Exclusive: Bill Gates on the importance of India in his career, Aadhaar and Donald Trump 06:37

The sparkle in his eyes, the enthusiasm in his voice, the seriousness of his purpose...everything is the same as it was when he was conjuring up new versions of the Windows operating system and MS Office back in the 1980s and 1990s. Only, now he is talking of financially empowering poor women and reducing infant mortality, among other things. On Thursday, Microsoft co-founderserved asThe world’s most generous philanthropist, whose Gates Foundation has invested over $1 billion in India, spoke candidly and passionately about his work, ideas and the dreams that drive him. Excerpts:Let’s start from a clear view that parents don’t want their children to die. Childhood death in India has come down a lot, but India’s childhood death rate and malnutrition rate are still significantly high relative to its income level. Of course there are variations: you have states that are amazing, like Kerala, and you have states that have a long way to go, which is where we focus.It’s true that anything can be made controversial. But remember, the vaccines that have been introduced in India were successfully used on millions of children before they got here.Well, the digital phone enables a lot of things. One of the pilots the Gates Foundation is running is where Anganwadi workers have a phone and they can see who the pregnant women are and if they’ve been seen enough times. What are the weights of the children? Which ones are falling behind the growth curve and need help?We are very enthusiastic about the idea of digitally empowering Anganwadi workers, even though it is in a pilot stage today. Over the next five to ten years, it’s going to be fantastic in terms of the quality of service, and the quality of follow up.Sanitation is about behavioural change. We do try to get word out on good health behaviours, like exclusive breastfeeding, through self-help groups. We have found self-help groups to be a good communication vehicle.Of course we would also like to communicate directly, but there are a lot of the people we want to talk to who are not yet the first owners of cellphones—say a woman in a village in a poor part of UP or Bihar, which are the two biggest focus states for us.We are also very involved with the government on making digital transactions better. We are very excited that government payment systems are moving to the app, which makes them more efficient, less corrupt.Digital revolution also involves asking people about basic government services. We are not doing such things yet, but only by way of example, people can say if the teacher took the class today or not. So a digitally instrumented government is a higher quality government.You know the payment banks just got authorised about a year ago. There is a complicated bootstrap, because first you think cash is the only thing.Once digital payments eventually catch on, cash will play a far smaller role even at the retail level. We are at the early stage, there are countries like Kenya which have what is called M-pesa. We have seen these things provide a huge empowerment benefit.When it comes to empowering women, phones are often owned by the men. So in India, I would say we put 70% of our efforts over the last five years on getting digital money started and on to critical mass, and only 30% into looking if it is being used to empower women. We have worked with the microfinance groups and over the next two years I would say we will achieve critical mass. Our role will then switch 100% to seeing whether it is being used in villages, is it being used by women, can you get agricultural credit in a better way than you did before, what does microfinance look like in a world of digital money and so on.The way Aadhaar was designed, there is no privacy problem with it. There are applications that are built on it that may raise issues. Aadhaar is just a 12-digit lie detection system. You come up with a 12-digit number and then it will tell if you are lying about whether it’s your 12-digit number. I didn’t read the Supreme Court ruling, but if you ask whether there should be a right to privacy, of course, yes! Governments can sometimes go too far, but the notion of Aadhaar inherently is against that.When you pay taxes, governments are allowed to see certain things, when they are deciding to issue your passport, they are allowed to see certain things. The fundamental problem is just to get the applications right.The irony is, I often tell Nandan (Nilekani) that if I would have done Aadhaar, I would have created more built-in capability but Nandan was very careful about not being intrusive. Now you can go to each department that’s using that and say to them “okay. what is this data, who gets to see it?”The big number we look at is underfive mortality, which has gone down dramatically but it’s still far too high. Six million kids die before the age of five, 5% of all kids die before the age of five. Before we got started it was 10%, now it’s 5%. By 2030 our goal is it should be 2.5% and to get from 5% to 2.5% you’ve got to handle malaria, diarrhoea, and pneumonia.There are a lot of mysteries in global health, like how much antibiotic resistance is there in India? How many kids are dying because of that? We have all these studies out but it’s still mysterious. We have always known that another cause of underfive mortality is because kids are freezing to death. So you do kangaroo care, you hold them, (share your body warmth with the child, like a kid in a mother kangaroo’s pouch). People are not going to hold them 24 hours, so making a one-dollar sensor that would flash or make your cellphone beep if the child is getting too cold could be a solution. There’s a lot to be figured out to get to that 2.5% and then get to half of that.The trends are positive. We need to do better on the health system’s quality, like giving the frontline workers cellphones and managing them better and making sure they are hired and trained properly.The total spending on public health is too low. Every other country that moved to middle income status spends over 3% (of its GDP) on public health. (The corresponding figure for India is about 1%). If you’re out of pocket (paying for healthcare) it can bankrupt your family. Most countries that moved to middle income status, provide insurance – either through the private sector or through government or some weirdmix. Even if there’s more money for the public side, that alone is not a total solution. We need to raise the quality of care and the Gates Foundation is very much a part of that but we also need this private insurance market for the health system to work.The biggest disappointment I have about India—though I am not an education funder—is the state of the education system here. It should be far better than it is today.Is government brilliant? No. There’s no country in the world where government is brilliant. Well sometimes, it is brilliant, but in general, governments are conservative. The total tax collection in India is an issue, hopefully GST can help the government get resources. But I’d say in health and education you can get more for what you’re spending.India will move to middle income status. It’s just a question of “will it be a lot later than it should be or will it just be in some states and not in others.” And time is on our side.Why? You have people like (NGO) Pratham. Just read their report. You don’t need me! We pick and we specialise. Nobody can do everything. And I’m very glad that a lot of Indian philanthropists have picked education as a high priority.I wish it was more visible in health. It’s more visible today than it used to be. But overall, while health spending has grown in absolute numbers, it has stayed the same as a percentage of GDP.This government has acknowledged the problem that India has with nutrition. That’s good, that’s an improvement. But they haven’t improved the funding for health by all that much. The level has actually been the same for quite a while.The previous government launched the NRHM (National Rural Health Mission, launched by Manmohan Singh in 2005), and they were able to do it because the economy was growing. The NRHM is an imperfect programme, but it was a great thing, bringing more money to the poorer states, and we tried to help out to maximise its impact. This government? There’s sanitation, there’s digital money, and these are the areas they’ve stepped up to.Most of the time, we work at the state level, we have to deal with different chief ministers. We go to them and say, “Do you care about health?” “Do you have good bureaucrats on this stuff?” and “We’re here to help”. Fortunately, I’d say we’ve had pretty good work in terms of those relationships. There was this time in UP—I won’t say when (laughs)—when health was less of a priority, but in the last couple of times, it’s been more of a priority, but still, there’s so much to be done.About education, I don’t want to be critical but I do want to create higher expectations. I am surprised that India hasn’t made more progress on the quality of education for the poor.Bihar’s come a long way. We’ve had continuity, not total continuity, but pretty strong continuity for a while now. The people who work for Nitish Kumar now are the people we’ve been working with for a long time.We haven’t made Bihar better than Kerala or something, but better than Bihar in the past. The vaccination coverage has improved a lot, delivering facilities has improved a lot.Right now, we are trying to fix nutrition. But there are a few districts that actually did raise their nutrition numbers in four months, so it can be done. These are governmental functions, and if the governments want to do better, we’re there to help them do better.We’re not a long term financer. We have a lot of money relative to philanthropy, but relative to 1.3 billion people, we have no money. Only the ongoing government systems have that. So everything we do, we work with the government, not around it. Sometimes it’s tempting to hire a bunch of people and do something separately. But it’s not self-sustaining.We have to be careful. If you pick a single metric to track, you can go after that and not get the eventual benefit you want. So how many of these bank accounts are being used? These payment bank accounts, where you don’t have to go to the branch and where the fees are actually low, they’re good. If we can get super critical mass of payment banks users, then it’s just common sense. We think that’s where the action is.It’s a tiny bit too bad that the push for the bank accounts happened before the payment banks were authorised. I’m not against those other checking accounts (the Jan Dhan accounts push launched last year), but I wonder if they will ever get used heavily. If you have to go to a branch that’s losing money on you, is there any incentive for them to do anything? Whereas the payment banks, the marginal cost of transactions is super low but it can be done without being a money loser for the cellphone company. It’s all subject to competitive behaviour.Likewise the toilets. Counting them is a good thing, but we need to ask if they’re being used. We map where the faecal sludge from these toilets is going, and the maps show that if there’s no emptying, these toilets are not being used or will become unusable. This is a problem not just for India. In Africa, a number of toilets were constructed. Donors came for a nice conference, and when you went back a year later, someone’s taken everything out and is using it in their house for some other function. You’ve got to be a long term player in these things. Making a toilet long term usable is not an easy thing to do.To the degree that it’s agricultural, from burning scrub, figuring out what’s the alternative to that and how do we train farmers to do that, we might get involved because we are involved in agriculture. To the degree that it’s from vehicles, we won’t get involved.To the degree it’s from coal plants, I’m personally involved in energy innovation, like shifting to cleaner energy—that’s not the foundation’s goal, it’s a personal investment. The foundation’s involvement in climate change is in things like giving people seeds that help them with changes in rain levels or heat waves. We’re very involved in these super robust high-productive seeds. The energy innovation stuff —the mission innovation stuff announced two years ago—I’m hopeful you can have technology that lets India have cheap, clean power. You can’t ask India to pay twice as much for power. Power is refrigeration. Power is air conditioning. Power is manufacturing jobs. Cheap power is magic stuff.I’m really happy that he’s running Microsoft, so that I don’t have to. I still love Microsoft, I still worry about it and I spend 15% of my time on it and Satya’s very good at using that time. He’s always telling me “Go meet this group. Are they doing a good job, let me know.”I’ve worked with Satya for a long time. He was always very thoughtful, very good at working with people, He has this very calm way of dealing even with very hard problems. Happily the board endorsed him, because I was so enthusiastic that he should be the CEO. Why is he such a good CEO? It’s hard to say. His book talks about his (quadriplegic) son – which may explain a lot. He’s a very Zen person (laughs). In that respect, he’s probably better than I was. I was too emotional –if something’s not going well – “This is terrible”. But it’s fun to work with him.There’s a certain type of IQ where I can give you a 500-page book on meteorology and you read it and you understand how tornadoes work. I always admired people who were good at that, and I thought if you were good at that, then everything else is easy. Managing people? Just use common sense. Understanding profit and loss? That’s just a little mathematical equation. “You’re a smart person. You know physics. Go manage this group. It can’t be worse than the Navier-Stokes equation (a complicated fluid dynamics equation),” I used to think. I was wrong about that.The idea that some of these skills were not correlated with scientific IQ, in fact, that some of them were negatively correlated, it took me a while to figure that out. Those who combine scientific IQ with people skills—like Satya –are rare. You have to learn to build a team with different capabilities and as Microsoft got bigger, it became more important. I’m a little broader in my understanding of different talents now.We have to realise that what may work in the US may not be applicable elsewhere. You can’t ask a country in Africa to do something similar tomorrow. The appropriate government policy may be different from what some western NGO thinks it should be. Government is the arbiter of these things, and you want citizens to be thinking of these things.No sector is immune from stupidity, certainly not the private sector, although there’s a self-correcting mechanism in the private sector as against in government or philanthropy. When you give people money, they always say to you, “Hey, that was brilliant”. It’s not like Microsoft, where if people stop buying your product, then you know it pretty quickly.Philanthropy as a percentage of the economy in India is probably not even 0.1%. In the US, its 2% of the economy, the highest in the world, though a lot of it goes to churches. Certainly, I think individual philanthropy is growing in India. I’m a huge fan of that. We should make it easier, maybe there should be some tax benefits for some certain kinds of philanthropic activity.But I think you’d get a lot of different points of view on required CSR. There are things like Microsoft giving software to schools, things in the line of expertise of that entity, where of course they should. But saying that companies should write a cheque for X%—will that be well spent? It’s a good question. There’s an experiment in India today on where the CSR money goes. When we went around asking “Hey, how can we get that money to help us with health projects” we didn’t get very far—maybe we weren’t creative enough.