Possible: Bill Gates on possibility, AI, and humanity

The very best founders I know are brilliant at building systems. They connect teams, they remove bottlenecks, and they eliminate single points of failure. And yet When it comes to their own wealth. Most are running a disconnected stack. A tax accountant here and a state attorney there, a wealth manager who doesn't talk to either one of them.

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Hey folks, Jeff Berman here. I am thrilled to share some of the new names who will be joining us at this year's Masters of Scale summit. This may be our biggest stage yet. Reed Hastings, Meredith Whitaker, Van Jones, Amjad Masad, and more. Will be there with us October 20th through 22nd in San Francisco. If you're building something great, or you want to build something great, We want you there with us too.

Join us at masters of scale dot com slash apply twenty six. That's mastersofscom slash apply. Twenty six. Hey Masters of Scale listeners, it's Reed.

I'm excited. to bring you a bonus episode today for my other award winning podcast called Possible, which I co-host with former CO of Do something dot org and my chief of staff, Arya Finger. Possible. Is about sketching out the brightest version of our future and mapping out what it will take to get there. In this episode.

We speak to technologists, business leader, and philanthropists. Bill Gates. We talk about his current areas of focus. Climate change енерджі Global health.

and education. And how AI Will help transform. Each of them. Stay tuned.

For a conversation with Bill. And if you like what you hear, Subscribe to possible. Wherever you listen to your podcasts. Now on to the show.

AI for матеріал сієнс біологі It is a A gigantic accelerator.

So take Whatever green product you think's can be the hardest to get the zero green premium. Ретник хард'ян бизне тус. are so phenomenal at accelerating all of these paths of innovation.

High. I'm Reed Hoffman. And I'm Aria Finker. We wanna know. What happens if, in the future, everything breaks humanity's way?

What we can possibly get right. If we leverage technology like AI, and our collective effort. Effectively. We're speaking with technologists, ambitious builders, and deep thinkers across many fields.

Ай, чиополітикс, мідія, хелкре, едукацію. And more. These conversations showcase another kind of guest. Whether it's Inflections Piece. OpenAI's GPD 4 or other AI tools.

Each episode we use AI to enhance and advance our discussion. In each episode, we seek out the brightest version of the future and learn what it'll take to get there. This is possible. How do you settle on a topic of discussion for someone with as much going on as Bill Gates?

He's a technologist, business leader, and philanthropist who works to solve some of the world's biggest problems, using technology to address poverty, climate change, global disease, and educational disparities worldwide. For just a snapshot of Bill's contributions to a better future for humanity. He co founded Breakthrough Energy Ventures, which has three point five billion to invest in reducing Greenhouse gas emissions. The Gates Foundation has distributed more than seven point eight billion.

To improve medical research. Access to immunizations. and more. Bill led the effort. To reduce

Global child mortality. By fifty percent. and continues to work to eradicate and lessen the impact of diseases worldwide. The Foundation's commitment To improving education in the US and abroad.

has been equally strong. As just one example. In twenty twenty two, the foundation pledged one billion dollars to improve math education in the US in the wake of the Covid pandemic. Bill is quite literally one of the most impactful people in the world. with a unique capability to steer technology that can change society for good.

So that's what we're talking about today. Climate change, medicine, education, and the latest in AI. Plus the way all of these issues will play off each other to impact our society. As someone with a broad view of cutting edge tech in these big areas. What opportunities is Bill Gates seeing, and what's the trajectory of nascent applications for AI in medicine, education, and energy?

Here's our conversation with Bill Gates. So Bill, we've known each other For some time now. We probably don't want to quite date it, but it's been it's been a while. And one of the things that I love about doing podcasts uh with my friends is that I actually in research learned some things that I didn't actually know before. And apparently There's this kind of trifacta of three criteria. Um it's

Uh will it have a big impact. Will you learn something? Will it be fun? Вота сама в проєкці. that immediately come to mind that are the kind of the most interesting that meet that trifecta for you. Like what in that goes ah that's something that met all three in his fun and exciting for you.

Well until Age twenty I got Two Read about lots.

And lots of things. Yeah, so I range quite broadly including auditing a lot of courses at Harvard that I wasn't even signed up for. Weirdly, then when I got into Software

I had to suppress my sort of normal desire to be polymathic. And be monomaniacal. And So from age, you know, twenty to Thirty five.

I didn't stay up to date on, you know, geology uh Uh, by the time I was thirty I started cheating reading. Uh some other things in particular Uh when I turned over the CEO role. So It's nice now.

That partly'cause the foundation touches on a lot of things. I do Yeah. range pretty widely. And there's a few topics like climate, you know, then you have to learn about weather and materials and

energy and Uh so it's a great excuse uh for Learning things. Nowadays Global Health gets a lot of my attention.

And so You know, I do put a lot of energy into that'cause it really fits all of those criteria. And it's such an underinvest field. You know, that you can

Invent tools that save millions, you can save lives. For less than a thousand dollars per life. But You know, yeah, now you've got climate, you've got AI. No shortage of interesting topics uh in in the world today.

For somebody like me and You know, my ability To know people who can help educate me in the online tools, the combination means you You

Don't have to worry about getting confused'cause someone I I know someone who'll Straighten me out. So one of your projects that actually hit all three for me is your recent Netflix series. I loved it. What's next, The Future with Bill Gates. And I will humbly say I think it has a lot of DNA in in common with this podcast. It's about the future, it's about what could possibly go right. So can you just tell us a little bit about How was that experience making that show? And is there any memorable moment, maybe an outtake that didn't didn't make it into the final cut? Well

Five years ago I did a Uh documentary with Davis Guggenheim inside Bill's brain and he picked Things I was working on that could fail nuclear fusion, uh, polio and

Uh magic Toilets that Don't need sewer systems. And that was an interesting paradigm, you know, why Was I

putting money into those when essentially no one else was. This one is quite different because it takes topics that like misinformation that I don't know the answer. I mean, literally that's one of the few problems I say, okay, young people We screwed this one up. You better create around it, you know, t is AI gonna help, is AI going to hurt. It was fascinating.

Talking through with my kids did they want To be on the series, you know, and two of them We're like uh that's Doesn't

seem like a priority. And then Phoebe's like, Yeah, you know, Dad, you you're so out of it on this digital stuff. You still try to send me email. Uh let me straighten you out. on these things, which you know really became uh the case. You know, I met people that I hadn't talked to Much before I'd never met Lady Gaga before. Uh

And You know, so that was kind of a privilege and in a way very Interesting person. You know, on the global health we had so much footage, you know, that's the one that I worry will any b

Will it get The viewership that the others will get because you know we really do know what to do in that space. It's it's kind of amazing and because it's far away. people I think would learn a lot because you know they they're not confronted with Five hundred thousand malaria deaths a year, and the fact

We see a path to drive that that to zero. I mean I think the tagline, come for Lady Gaga, stay for global health. Like you've got it. You've got it. Absolutely. Yeah, Netflix might use that on its rotation. What are you? Currently. most excited about

In terms of the Technology That will Make a massive difference of changing what's possible at scale. Yeah, the current

Situation is that all the things I'm working on that relate to innovation, whether it's climate Or These health issues a lot. Malnutrition, infectious disease.

Or, you know, digital tools for say teaching or Or health. The pace of innovation is faster than I would have expected. And I you know, I have a pretty high expectation. I go to product meetings and say, How come we can't do this twice as fast? Just do that many times a day. Uh and yet innovation is even exceeding My best Hope so

It's super promising. In all of those areas, you know, take malnutrition. almost half the kids in Africa, their brain and bodies don't develop. And we haven't understood chemically they're getting enough calories You know, what are the micronutrients or the mix in their diet That causes them

To be on average Five inches shorter. than they would be and you know twenty IQ points less capable. than they should be, which for them and their countries is pretty profound. And now

with the latest tools of science, you know, looking at these bacteria in the gut. The microbiome and okay, how do we influence that? We clearly have a path. to solve Malnutrition.

And You know, people should go, Wow, that That is a very very big deal in terms of of the uplift that comes out of that.

You know, on the energy side Things like Either getting fission or fusion. To provide both very cheap

And constant reliable electricity You know, that's a longer time frame in in the the fusion case. So but You know, there's a ton of companies I'm invested in

In five. So Deep understandings of complex science things, including All these diseases This next twenty years is going to be mind blowing.

And actually knowing a little bit about the Malnutrition. Go the next level depth on the bullion so make it a little bit more tangible so people can say, Oh my God, we're there now. Yeah, well with malnutrition If you don't get

The right vitamins Dream pregnancy or in your first several years. You can never catch up. You know, so it's a sad fact you don't get to go back and say, Okay, eat your Wheaties.

Uh And you get The IQ points and the the physique capabilities And it's weird.

that you're just missing small amounts of things like vitamin A and vitamin D. And so how do you solve that? Well You could fortify a food. Like US breakfast cereals are Are fortified

But you have to find some food that even the poorest Households who are the most likely to be malnourished'cause they're not getting Eggs and and milk and meat. And it turns out these Bullion cubes are preferably bought

by low income households because it gives them something tasty and it's very cheap. Relative to how tasty it is. So now we're going to put a lot of vitamins, particularly vitamin A. into that billion cube, it raises the price about three percent to do that. Something I love about what you do is you identify the problem, you bring data to it, you test it, figure out like especially because you're working with populations who are low income in Africa, the poorest of the poor, like even if you're raising the price three percent, you have to build that into everything that's happening. And so now We want to get into all of the different areas that you're focused on. And so let's start with climate. Uh I was lucky enough to have dinner with you and Reed and a few others a few weeks ago. And one of the interesting things you were talking about.

Is you were saying how one of the interventions that we need to do is around cows. I feel like everyone sort of knows that maybe c cows contribute to climate, but you were giving me very specific interventions that can move the needle. Could you talk more about those? Yeah, so there's basically Cows. Or about five percent of global emissions. Which is pretty unbelievable. Wild.

And If your goal's to get to zero You You don't get to skip the cows or the steel or the cement or you know, any of of those big areas.

So There's a whole class of solutions of making meat without cows. Uh today it doesn't taste as good and it costs too much. It's going through a little bit of a lull, but you know, those companies and possible beyond Memphis and others

uh are pursuing that. In terms of the cows. We actually have we pursued Many solutions. So one is To vaccinate the cows in a way that their gut p

bacteria that emit The methane which is also called natural gas or siege four, which is uh the second most important greenhouse gas. You can vaccinate them and that species of bacteria. uh isn't there. Their stomachs are very special because they can eat grass. You know, it's a three stage

fermentation process basically There's another way you can Change what they eat. And you could p either put that in the water or Their feed.

There is a drug to change. the microbiome not a vaccine but a drug. That looks very promising. And then there's a solution where you stick a Sort of a metal Yeah.

And it actually burns the methane. And all of these look To be quite cheap. And implementable even In Africa. And so I'm

You know, this is one where I wasn't hopeful. When I I got started a decade ago and now It's just a question which solution for which country ends up being the the best. Yeah, it's some of the it's similarly amazing to like what you did with the toilet and all the rest. It's like

Doesn't look like it's possible. Now it is, and it makes a huge difference. One of the other funny things when we were talking about the discovery of the work around cows over the dinner tables, once you focus on it, it's not just the systemic climate change, but it's also the questions about like, for example, what this can do for quality of life in Africa. Right. So say a little bit more about like milk production and cow breeds and other things, because it's like I never thought Bill as the cow expert, but here we are. Well I didn't grow up knowing much about cows. Uh So protein is a very important

part of a good diet. And Foods with proteins tend to be very expensive. So if you can make Chickens and cows. Live longer and be more productive.

Then That's super beneficial. So the West Has taken these cows, these Holsteins, and driven them up. So they make thirty liters of milk a day.

Whereas the normal cows uh make less than three liters a day. So you have this factor of ten Productivity through the genetics of that cow. Now you can't just fly Holstein down to Africa because the heat and the diseases. It's not

adapted, but if you do the cross breeding properly only giving up a little bit of the productivity, say down to twenty liters Still a factor of six better. you can improve those cows. You also take the idea of grazing where the cows going out

into areas that are now being fenced off. And you can change it so the cow's largely stationary. And the food which they call fodder is brought to the country, so you avoid these Incredible complex Between the

the grazers and the the other farmers. And so it's one of the most exciting foundation things. And once you we do the R and D and get those good cows in It's private market sustainable. We're further along with chickens, you know, so I was in Ethiopia a few weeks ago seen that we've cut the price of chickens in half. Women are the who do this.

You know, they make extra money. They give some of the extra eggs to their kids as well as uh selling them. So It's taking But it's leveraged off of the West, you know, that spent the last hundred years. Doing selective breeding of uh both

Uh chickens and cows. So obviously when we're thinking about chickens and cows, it's climate change, it's malnutrition, it's uh potentially war and conflict. If we l zoom out on climate change, What is the sort of statistic that for you sort of represents the gravity of the situation, or what are you working towards to decrease when you think about you know climate in general? Well the The size of the emissions

and which is over fifty billion tons CO two equivalent per year. Uh And the pie chart. Of okay, you know, what are the big five areas, you know Like transport is one of the big five, but then

You know, cars. Planes, boats, trains underneath. That You know, electricity, which is coal, natural gas. uh industry

Building agriculture. You know, I want everybody to have That pie chart in their head. And

You know, the theory of change, which is That we need to make All those things Without them costing more. You know, I always say there's two numbers, fifty billion and zero. Uh zero is what we want emissions to be.

And zero is what we want the extra cost. of green cement, green beef, green rice. Uh you know, green car. Uh we want it Even at the low end where you park on the street.

Because Even if the world should pay A lot For green things. They won't because

It's a Global problem. The real problem is for future generations. The negative impacts have been somewhat overstated for the current generation, actually, but The because it accumulates and gets worse over time, if it causes us to help those future generations that You know, uh it's not

Not a uh a terrible thing. The damage is mostly in poor countries. Uh it's almost like people didn't realize weather's always been a problem and they're like, Oh, every bad weather thing that's climate. No, there was bad weather. Uh before and it's you know, slightly getting worse, but it's near the equator where your absolute temperatures To feed

outdoor work and the current crops that we have. That's where your getting into conditions that humans have never thrived in. Well on the electricity side, and we'll get to nuclear in a minute,'cause you and I share a passion and that being a great source. And there's

All kinds of things. One, the need for electricity. Second, you have Good, scalable, clean. cost effective power, you can solve all kinds of ills. What are the other Energy sources

of renewables and green energy that are capturing your attention. Outside of nuclear Well of course We wanna keep driving solar. to be cheaper, you know, that's gone way better than was

Expected uh and there's some new Things you've seen Perovskite's little Drive the efficiency up of that. You know, we wanna drive wind costs down, including offshore wind, which is still quite a bit at a premium. We wanna improve energy storage.

But it's not realistic to think we'll completely solve that problem. Which Just why why You you need nuclear in in the mix uh as well

Geothermal actually looks like it might play a role. You know, the Western half of the United States actually has Pretty good hot rocks. Uh And

Then there's geothermal companies that want it to grilly deep holes. Uh that's more early stage, but Fervo and one other company. Are showing that they can actually

get reasonably good pricing and now they're scaling up. Uh you know, Google just Yeah. purchase agreement at a at a premium to help them scale up. Which is uh you know, all the tech companies are

Very oriented towards not raising their emissions which will Take advantage of that to get these products onto a learning curve. You know, eventually we want

Tav. A zero green premium, but somebody has to help Get us you know, which solar was very subsidized and then it it under certain definitions has now gotten to uh A zero green premium.

There's a few things like title that probably is pretty limited. uh you know solar panels in space Maybe, you know, some people have even talked about, okay, put the whole data center up there. Uh it's just bits. Uh actually moving bits from space to ground is easier than moving energy uh from space to ground. So You know, and particularly'cause launch costs are down, you can at least dream of of those things. That's

Kind of. Uh A far out. Thing but Uh you know, should be in the portfolio of of innovation.

it's useful to highlight for most people is they like for example the current discussion of AI is always gonna be all this electricity, but the investment that all the hyperscaler companies are putting into the kind of how we make clean data centers, how we have clean power and all the rest, is like that subsidy for the R D and these advanced purchase agreements are exactly the kind of thing where you kind of like different ways of conceptualizing public private good. Yeah, I mean um I say that

Річ кантріз, річ капаніс, а річ індивідуал. should bootstrap the market for these green products. You know we should buy clean aviation fuels. uh that for private aviation which That would definitely

be a good thing because it would get the volume to go up so that eventually we can get something with a uh either a zero or very low green premium into commercial aviation, which is another Six percent of the emissions we have to get all the way to zero. So Yeah, the the and it's important to remember that all that data center demand, it's big numbers and it's coming quickly over the next six or seven years, but it's not as much as electric cars or electric heat pumps. So we've

Our climate solution Because you can't avoid using the energy somehow. The only non hydrocarbon Way we really know Yeah, how to make energy is a

in a portable form is electricity. So we get rid of coal and natural gas. But you have to make a lot more electricity. to replace the the either heating or industrial uh capacity that those direct hybrid carbons provided. And can you tell us a little more about solar? You were telling me actually about the amazing increase in ability of solar panels and like what percentage of the sun they capture for energy, which was fascinating. But you also said that you don't think

you know, batteries aren't gonna be here in time. Or is it we just need more time to get to batteries where they are, the cost is too high, and I feel like not having the batteries we need is what is inhibiting solar from being the energy source that can save us all. Most places we should be adding solar as fast as we can. And we're actually, you know, limited by the grid capacity. So I love solar. Yeah, the efficiency you know, started out at like ten percent. It's in the twenties now, it could get as high as forty with

New approaches over the particularly profite over the next But It's not just a twenty four hour storage problem. Lithium iron batteries are now sodium.

and others will solve your twenty four hour problem, but you have Periods of time. Like the Midwest gets a cold front where you get ten or twelve days. All the batteries Ever made in history.

for every car, every computer wouldn't store a day of electricity and If you're only using a battery Once a year. That is you charge it and it's sitting there for this unusual thing. That's super expensive electricity instead of Getting the capital value out.

Three hundred and sixty five times a year, you get it at once. So various seasonal and bad weather things. uh where you you don't want to shut up power, particularly if it's being used to heat homes. It's way more complicated. than people think. Electricity doesn't move long distances today. It's mostly coal or natural gas plants that are fairly near

to the usage and Yes, there's innovation and transmission Actually fairly exciting stuff. But we're gonna have to have a mix. You know, and particularly if you look at a country like Japan.

Where There's Essentially almost no Solar potential there, and even the wind has

periods where you have too m much or too little The US happens to be very blessed. We have Incredible wind and uh solar

resources and These open source models That are now we're modeling out okay, what does that energy system look like or seen okay, when can we get there? And there's a lot of these goals that

Uh are not well thought through. It's gonna be harder than We wished it would be. Well one of the things that you already mentioned gestured at before Is a part of the reason why we need

Nuclear. uh fission and fusion is because Awesome renewable solar, wind, uh hydro, et cetera. Um, well, hydro Can you

Do A little bit more twenty four, but yes, but they have they have limitations on when they generate and when they don't. And so and then battery storage is a challenge. And so you and I have invested in some fusion things together. Uh say a little bit about What's the hope?

Uh and the and the possibilities for fusion. Vision is where you take the big atoms like uranium and As they split. You get energy. And fusion is where you take the small atoms Primarily hydrogen as you put them together.

You release energy. The Middle of the periodic table is Uh the most stable and so you're getting relativistic energy, uh Uh through the

That mass decrease. Fusion is very difficult. Uh it involves you know, temperatures that are like the center of the sun, you know, millions of degrees. And so that's plasma physics.

Which we know a lot more about, you know, we're using AI tools. to study those things and now there's a variety of techniques Tokamok. uh which uh Comwealth Fusion system is using bean The one with the most credible

schedule for say ten years from now. Most of the others are probably more like fifteen years away. But At some point fusion energy will be extremely cheap and It's not it doesn't have the same waste problems that vision does.

You know, I think those are s are solvable problems and I'm Investing in that because That's more like a six year time frame if everything went Perfectly. So we society as a whole even though a lot more money's coming into it, we're still under investing in fission and fusion, given that the value of

Chip electricity specifically is so Fundamental to society. I mean if you know somebody says to you we have a water shortage. No, but

There's a lot of water. It just takes energy to move that water and desalinate it. So if energy is cheap. You have infinite Wonderful water everywhere in the world. But the energy is is to Expensive right now.

To do that at scale, even recycling things. You know, why can't we you know, atoms don't leave the planet. Tiny bit of hydrogen, but It's all there, and the reason we don't is that the energetic costs of

restoring things to their original state is is too high. Well one of the um For our listeners, uh, super awesome way of kind of actually using nuclear fission waste as fuel. And so getting a compounding effect. It's one of the things that you guys have been working on for Number of years, maybe.

the vision company TerraPower got started. Yeah exactly. Um now one of the things that always bemuses me about some of the current public dialogue around AI is like, oh is this gonna accelerate climate change because of the electricity costs. And I think what you know most of these people are not realizing how we can also use AI to help us with climate. So because it it like if we can get a lot more intelligence applied to various problems. That can help us with climate. Say say a little bit about how you're thinking in that arena. You know, the extra electricity load Is

You know, it's there, but it's It's like a ten percent. Add on. You know, it'll challenge the way that we do green accounting A little bit. And I wish

Fission and fusion. Were sooner. Because this sort of gold rush for AI back end capacity is kind of the next eight years. And even fission

will only be able to make a modest contribution in the twenty thirty Time frame. to that Uh I'll let Christie Supply.

So the value of AI in solving the scientific problems of Okay, how do you grow how do you make plants more productive? Okay, you model photosynthesis and you model how you change The plant. genetics in order to double

The productivity That's a very profound advance. Improving photocytic Inefficiency. In fact You know, because it's kind of a far out

is the primary Thunder of that as as the we show. That it it can work. Okay, other

Other than People will come into that. But anyway, AI for material science uh biology It is a A gigantic accelerator. So take

Whatever green product you think's gonna be the hardest to get the zero green premium. rethink how hard that's going to be because the AI tools are so phenomenal at Accelerating All of these paths of innovation.

Yeah, and actually one of the things I've been thinking about is like While it's a big electricity cost for training these scale learning machines. Once you have that intelligence, like Like that's how we've made everything, is through intelligence. Once you have that intelligence to amplify across the board, like applying that to climate change has gotta be a like there's gotta be some multiplier effect of we get this much actually savings and carbon and other kinds of things through the application of this electricity. I I don't know what the multiplier will end up being, but

But I'm Certain it's there. No, it's absolutely there. There are some goals like Not going above one point five degrees. That even with AI being a net

positive contributor Because of the difficulty of scaling in all the areas in all the countries, Uh You know, some of those goals we will miss. But the

We will avoid the level of heating that would be Disasters and we will need to do some adaptation. Particularly in

In poor countries. So I wanna switch gears. Another area where I think you're probably best known is global health. And I think it's an area where AI can Do so much. And my husband is a public health data scientist, so he's particularly excited about this area of the interview. You have focused on the eradication of disease. And I think, but fact check me, in nineteen eighty the WHO declared that smallpox was eradicated, and that's the first and only disease that we have eradicated. You said let's tackle polio, let's tackle malaria.

How do you pick what is the next disease you're gonna tackle? Like what an amazing ambition. And then how do you go after it? Yeah, so most diseases We're going for a Burden reduction. Only very few diseases should you try to go

for eradication because it's very, very hard to get to zero. And Right now with polio You know, we're in Afghanistan, we're in Gaza, we're in Somalia, we're in DRC. And you know, we're having to execute high coverage vaccination campaigns against Misinformation and violence.

In the toughest places in the world. So it's very very hard. Polio's close. There's one called Guinea Worm, which is combined to Africa where you know, President Carter just got to a hundred. He's been a a champion of that. Uh so We're hoping he'll be alive not only uh to vote in the election, but also to come to the guinea worm celebration party. It's gonna it was gonna take a couple of years, so uh he's gonna have to hang on a little longer.

So the magic thing that happened at the turn of the century was People got serious about global health about really measuring Okay, kids die of diarrhea, but what cause that diarrhea. They die of pneumonia, malaria. Okay, it's more

But let's even though there's no market The people who died of malaria happened in kids' ear The it's not like you can make a business case of Hey, go to Silicon Valley and do a malaria startup and you know, look at that spread sheet. Uh the line that says life saved will look good, but the line that says uh profit will have a lot of red numbers because uh you They can't.

afford these tools. So medical science is very distorted towards Rich World. conditions and even amongst ritual conditions towards Cancer and uh A few.

other things. So the incentive system is in a potential could be improved. But the Gates Foundation, that's our place we come to fill in is that the things that aren't market driven, like getting diarrheal vaccines cheap enough For all the kids of the world, not just the rich kids who don't die of diarrhea, but the The it that also used to be a half million, now down

So as we went From ten millian under five deaths per year. in the at the turn of the century to five million diarrhea was one of our best pneumonia We got a vaccine out for that, which was a very expensive vaccine that We

Worked with all the vaccine companies, Western and Asian to get those prices down. And so we're c we're basically driven by The inequity where we say Why do mothers die in childbirth

twenty times as much in Africa. Why do kids die fifty times as much? In their first five years. In in poor countries. particularly Africa, but also South East Asia and so we're

You know, taking all of those and saying, Okay, let's find the best scientists, let's understand the field conditions. You know, is this stuff deliverable? Uh, will it be accepted? You know, we have crazy ways of killing mosquitoes. Yeah. That alone doesn't get rid of malaria, but If you

Treat a lot of humans And the reinfection rate has been massively reduced. then you can get to the point the US got to because we had malaria. where you've cleared during the low season That's the

uh winter here in the dry season there. You've actually cleared the pious site, so there's no humans, so there's no reinfection uh taking place. And You know, in the next Hopefully well, less.

Then than twenty years. We have five years now we need to do the tools. So our goal is to finish polio during this five years and then with new tools get the credibility to get the world To fund uh a malaria eradication Starting in twenty thirty. Totally awesome. One of the other projects we work on together is AI and drug discovery.

And so this is one of the ones I think uh we may actually even begin to see You know, some of the earliest You know, kind of. Global benefit. From so where in what areas of AI drug discovery are you kind of most focused on and think can make a kind of a global health difference?

Yeah, so Understanding protein and molecular shape space is a perfect AI problem because We have databases the protein database that

Yeah, we have Uh Hundred and fifty thousand molecules, we know the shapes and so it's We've trained AI on those. Their ability to predict the shapes and therefore the drugable

Sites. In these Proteins. Uh You know, that is accelerating medical discovery. There was actually a company called Schrödinger

that was doing it pre AI But now there might be twenty times as many people. Uh and Uh progressing much faster because AI

Is is very, very well suited to this. And eventually AI won't just small the low level what the shape is, but it'll model the cell and the organ and the organism. And so even complex disease dynamics You know, it's beyond human understanding to m map out all the different things that go on. The AI models as you gather the data, which

will be the limiting factor will help you understand you know, overnutrition, malnutrition, uh way better. than we do today. So You know, most things Paside norlogical.

In the next ten to twenty years, I would say the likelihood of Dramatic uh medical advances Even in lurological one thing, Alzheimer's.

Uh I'd say those will be solved. And I love talking to these companies about okay which part of the problem they're solving. I mean, one of the things that strikes me is I feel like it's super fashionable today to be, Oh, the world is terrible, the world's a dumpster fire, it's getting worse. The past thirty years have been horrible, the next twenty are horrible. And yet, talking to you, I'm like, No, stop. If we actually look at the data.

Things have been getting better, especially in global health over the last thirty years. Often because of AI. The future's bright. There's so much that can happen and You just sort of touched on not just sort of the technological progress, but also some of the sort of bureaucratic, some of the some of the other things that perhaps

AI or or else can unlock. Are there things that AI can unlock that are just Boring administrative or helping healthcare workers that aren't sort of about cutting edge technology, but are other ways that AI can help in the public health field. You know, in the same way that the microcomputer revolution Allowed me at a young age to think okay, computing will be free. Therefore

What would an individual do with free computing. Uh And You know, Paul Allen and I kind of saw that and said, Okay, software's the only thing that will

Hold that back. Whereas older people kinda thought, Ooh, computers are expensive. And so the idea of oh it'll be doing spreadsheets of word processor, they'd be like, Are you kidding me? Uh that's just too expensive. Here It's even more mind blowing that You could say White collar.

worker capability and eventually although Robotics is still uh very specialized eventually horizontal blue cor color Productivity will be very inexpensive. So you know, I take an MRI diagnosis that a friend has

And you know, chat GPT Does such a good job of explaining it. Uh You know, and showing you know where Got that material.

The creativity The fluency is kind of mind blowing. And so all of us should have This crutch. Um

Yes, if you just want to know what fertilizer is, Wikipedia was good. But if you want to know what a trip with a sixteen year old for four days with a budget of four thousand dollars to Italy in August looks like. Nobody wrote That thing but the the AI Uh If it's connected up properly.

It is mind blowingly Good. at those things. So we're already all Yeah, in our Life of uh

and writing poems or uh speeches or uh understanding or having complex material summarized. You know, we're already getting uh Uh A huge benefit. And

You know that You know, a lot of white collar work. uh, you know, should already be either more productive or You know, drive towards towards higher quality.

So actually one of the things that this conversation's reminding me of that I haven't actually ever asked you is Um so You know, there was this decade or so of a lot of focus on personalized medicine.

Where are we at currently on that? Is that improving? Is that is the is the promise of that Turning out at all? I always And put off by people's fascination. With

N equals one medicines. Uh You know, a half million kids die. Uh malaria. You know Millions of people are diagnosed every year with Alzheimer's.

So I'm just The impersonalized medicine guy. I'm like uh The world does not have the resources. If some super rich person, you know, funds that maybe it helps the scientific

Discovery. But You know, I couldn't Bring myself To be involved with that because

It's so unjust to take fine resources. Eventually, yes. Understanding everyone's genetics and saying, Okay, your drug dose is different because of this Uh and so You know, I'm I'm kind of taking a provocative position uh on this. The the science that goes under that name is very good science. The people who work on that are very well intended. It's just

You know, we have the rare diseases. We've created such an incentive for them versus Widespread conditions were not really Uh allocating Not effectively, particularly I mean the insane stuff is the the diseases of the the poor countries.

So can you actually say more about you've traveled recently, Africa, Asia, all over, about the conditions with healthcare workers on the ground. What have you seen there and how can we help improve them? Well, people should understand that Most People in sub Saharan Africa never meet a doctor. Not when they're born.

Not when they're sick, not when they die. And so it's this is not a doctor's thing. So your image of healthcare. Healthcare For most people In those countries is primary health care. A modestly trained person who can give you some antibiotics, bednet.

Vaccines very, very importantly. To give a Uh pregnant, they're Prenatal checks. You know, now we'll get an ultrasound.

evaluation and we'll see okay which ten percent of pregnancies might be complicated and then the woman Does it Need to get to somewhere Where there's trained personnel who could do a C section. So we can see with this. AI trained ultrasound. Is it going to be a complicated pregnancy? And the predictions are

stunningly accurate. And go to the all that trouble, which you couldn't afford to do for all pregnancies and You know, so the greatest shortage of doctors in the world is there. And so the idea that in native language through your smartphone

Which Okay, not everybody has, but time's on our side. Uh even in the The poor countries on this. You will get health advice.

And a lot of the diagnostics tools Well Be available at a A point of care where individuals Yeah, can take a

A lot of people experience this with lateral flow covet tests. You know, now we're trying to convert those to be Uh point of care, but Uh molecular Tests and and still Super

cheap, but also more more sensitive, more uh Accurate. And so healthcare is You know, it's in a We only have a hundred dollars per person per year.

Versus In The U Where we spend fifteen thousand per person per year. So it's

You know it's a Hundred and fifty. Times. Different And

You know, in fact, there is triage involved. And Okay, which things should you treat Now even things like blood pressure, cholesterol.

Obesity. My hope is that not only are the cost of those treatments going down, we're also going to put them into forms where it's like yearly dosing. And so the cost in the delivery system. I'm getting GLP one. To

All Africans you know, ten, fifteen years from now. You know, we'll be able to do that. So in addition to the elevation of humanity through

all forms of kind of global medicine and what is actually in fact healthcare. Uh education. is another area that you and the and the um foundation work on intensely. And you know, obviously

people have encountered AI a lot with this. You know, it's kinda like, you know, what is what does it mean? Um what are some of the The kind of Maybe more surprising or

other kinds of use of AI in education, whether it's, you know, kind of a globally available tutors or other kinds of what are some of the AI for education for the world that's kind of captured some of your attention. I think the first thing to admit is that Check Lovers like myself.

the benefit of technology being used in education For our whole career. And The actual benefit

For the average student has been very, very modest. If you're a motivated student who's Can get on. Khan Academy two hours a night or watch YouTube videos about Photosynthesis wow інопі.

We are able to learn In a way that's Unprecedented. You know, there's a company called The Great Courses where

I When I'm on the the treadmill I love. watching uh those things. Just so much great stuff out there. But the current math achievement of a high school graduate in the US І знад єрська. It's not like medicine, uh where there's

new tools and new understanding. If if I said oh in nineteen hundred the best math teacher Was then You couldn't contradict me because it may be true. And so We've done a lot. And

You know I'm I'm a believer, but AI Because of the fluency and personalization I think we We can Um

very high aspirations of how we mix social experience in the classroom, experiences with the teacher and Working on your own. That correcting your pronunciation as you read things.

immediately telling you no you didn't get this math problem right. You know, not turning in homework so two days later after the poor teacher spent all this time, you're like, Well Was that a manipulation error? Or was that a conceptual understanding there? The AI Uh economy goes

on the cutting edge of this, but there's others like C K twelve Mini. They it'll say yes you you Those two minuses you didn't cancel those, uh properly as opposed to no, you set the problem up wrong because you know these two trains, you didn't get the when they pass each other

algebraic equation properly. And You know, so the The idea that it will learn how a tutor keeps students motivated, you know, using the domain like sports or health or construction that

the student can relate to The The promise of having fantastic personal tutors In the inner city U S and In poor countries is

super exciting. And you know, talk about an area that's underfunded, you know, global education is and The magic formula for countries uplifting themselves is Have good health and good education and then

Their economy grows. their tax collection grows and they're they're very self sufficient. And that's you know, why we want to help countries get out of the poverty trap, not because it's an endless guilt thing, but If we help them get their Not only morally, but

economically stability in a m many good things flow. from those those countries being well off. Global education It's a very Underdeveloped.

Field But particularly now with AI. You know, I'm encouraging philanthropists

That There are things like structured pedagogy. Uh, were the teachers given a A very clear way of Teaching.

That we are seen Some some very good results. No, I really appreciate I think some people are like, oh, the boy who cried wolf. It's like you told me 20 years ago that, you know, MOOCs were gonna do it or that whatever. And so, you know, people are skeptical. It's like are we, you know, are we finally there? Can you tell us more about the First Avenue Elementary School in Newark? And obviously you're super concerned about equity. Is this something that is replicable that could scale? Well, so I love Con Academy. But it was mostly used by motivated students. And so for the last I think it's like eight years.

They've been saying, okay, how do we get into the classroom? How do we work with the teachers, explain the stuff. You know. Yes, the computers, the internet stuff is getting more pervasive. The pandemic actually helped a bit with that. So Saul and I were amongst the first two people

Who open AI was nice enough to let us mess around. with early chat GPT four and a lot of the cool things like having it Uh write songs and poems. Actually Saul taught me. That stuff. I was like, I wouldn't have known to ask. It can write like Shakespeare? Wow. Uh And so he

You know, it's put a lot of con resources in. He gets support from the Gates Foundation and many others, has created this condomigo. Any Last school year Yeah.

uh in a small number of schools, but including this New Jersey Newark, New Jersey school. And so I went there to meet the teachers, to meet the students. And C Yeah, so you meet a kid Who clearly is ahead of his class.

And sort of the factory based model of You know, thirty kids in a classroom. You definitely have a problem where you need to do remediation and catch kids up. Bye. It also you're also

Pained by That kid who's ahead. You know, and maybe checking out or being dis disruptive, and yet, you know You'd think wow, we want it

drive that. So the personal tutor aspect Allows that student be off on his own, sometimes helping the other students. And this, you know, con dashboard.

along with the Clonamigo, which is seen You know, so when you walk in and you're teaching in the morning, instead of people handing in homework and you have to deal with it, you just go to your dashboard and say, Okay, who connected in last night? W how many hints did they need? How far Did they get in the progression? Uh

And You know, you you're giving feedback, you know, you can have the parents connected up to that. Even the thing where a paper gets turned in. You don't turn in the paper. you turn in the AI session, so you can just say to the AI, Okay, how much did the student

Do. What's your suggestion on Uh how we get them to either Help with the first draft or help with the The grammar, the the The logic

So It's great to see it mean there. And seeing it in person Reminded me of embedding it in And

Always with teachers whenever you have some new thing. There's maybe ten percent of the teachers that latch on to it and you get these great results, and then when you tell the other ninety percent you must use this, those results. almost always just disappear. Uh and so okay, how do we make this one One that that scales

You know, so that humility Of how far we haven't come is even with AI, we ha we'll have to that but I What I saw made me even more optimistic. So one of the things that

people sometimes miss about the approach that you and the foundation bring these problems is, you know, not just quantification. of like okay, cost per life saved, et cetera, but also the systems thinking. And so what are some of the Kind of Non tech related

Lovers. for change in education. Like what are some policy things that either we as as Americans or you know the world should be thinking about to improve education? And it's a lot of very good data about Not having cell phones. in the school and

You know, some great work going on there. There's very good data about Boys should probably start later. Then they do school. School day should start later. There's all the learning out of the charter school movement.

Which It's hard stop because it shows that long school day. Long school year. are incredibly beneficial. Engaging the parents in

A You know, here's where your kids having challenge and comp communicating with them, although these digital tools are gonna make that Far easier for the parents. Who want to engage in that.

A you know, we're seeing now in in communities where there are charters The even though most of the kids are in the public schools, those public schools Essentially compete. They either Adopt those practices or find their own ways. So we're you know, there are places like New Orleans or

DC or Austinware. School performances up. And so we oughta make sure that even as we Try to put AI into this.

Some of those lorines are incorporated. I mean, amen. As a mother of three boys, I'm like, How are they gonna compete with the girls? What is happening? So to switch gears from education, I think I'm gonna steal one of your own questions, which is if you have the opportunity To meet with someone from the year twenty one hundred What would your questions be for them? Wow, how did you

Deal with the the AI challenge opportunity. You know, did You know, you you said earlier that I have this view that life is improving, which is objectively true, there's always footnotes like nuclear weapons, bioterrorism, and now AI needs to be added to that list.

But You know, the past fifty years Life in general, if you're a woman. If you're gay, I mean They

It's kind of sad in a way that because we're so problem oriented. We're not very reflective about Hey Five milyen kids a year aren't dying. You know, like you meet with climate people and they say, Oh no, climate's gonna ruin the world.

Do you think you're gonna go back to ten million a year dying? No way. You're not going to go back. We it is a super big headwind because of the impacts through agricultural. So you know, I bring my hey the world is pretty good, but that twenty one hundred person I hope to hear how they avoided I'll call it the four footnotes. AI

nuclear weapons, bioterror weapons, and polarization. You know, people being able to get along and cooperate, including in How governance Adapts. You know, which AI will force governments

To Come up with Different way of taxing people and Regulating things.

And it's a little scary. That it's happening at a time when the The Broad Trust. in government is Is

Yeah. A very low point. Both relatively and Absolutely. What are some of the things that you think

People should anticipate coming. With AI in the next three to five years. Well, it's so mind blowing, you know, sometimes hard to get your hand head around it. No one expected the white collar thing to come before the blue collar thing. You know, so in

Like life three point oh they have these hills where the computers are doing the easy things and you know, warehouse work which we can't yet do, was down there in the lowlands and helping diagnose, you know, was way up the hill or writing legal briefs. Our code. Uh and so it's

were surprised at that order, but Yeah, the So called blue collar horizontal robot. That can be told You know, go to this construction site.

And help, go to this restaurant, go to this Hotel and clean the rooms. You know, even if the price is such that in the home it only Drops by for an hour. uh doesn't live there at

At first You know, that those things Or I believe Within

within easily within the next decade. Mm. Well, and actually going back to your original vision of uh PC on every desk with software that would help people do their work and lives and so forth. What do you think is gonna come now that I I think a lot of people haven't realized that part of what's happening with current AI is Essentially the

Largest programming language will be natural language, e.g. English, and everyone will have a coding assistant, not just the PC, but a coding assistant. What do you think going going back to those kind of earliest what do you how do you think that will transform the world? Well the ability to navigate data, you know, which A long time ago you had to have some IT guy write a thing and You know, okay, what's the header and footer and you know, report there's a thing called RPG report generation language, and you know, in Cobalt, you have this section in the picture. Anyway

You know, a lot of that stuff. It's so obs obsolete. It Yeah. It just makes you laugh. The idea you can sit down and engage

In a dialogue about data in a very rich way. Means that You know, are ability to run businesses better. you know, understand pot like adapt

to changing things will be so incredible and It won't require custom software. And in fact The whole c complexion of the software market, how many applications will there be? You know, at first what we have is everybody adding AI to every a application and saying, Okay, pay me extra because now I got a little AI. But in fact the number of applications you need

You know, think of a college which has a scheduling app, uh finance app, uh Support the The student app. Yeah.

That should all be one thing that every encounter with the student to the college is Oh Uh maintained in a rich way. So the software Software applications

Will be very different. And I'm you know trying to figure out okay, how quickly does that happen? It's incredibly beneficial that. These this software is more adapting to you, including creating user interfaces dynamically, than you going, Okay, I use this software package for this, and then I go to this website and do this. You're a low level clerk, you know. Even looking at your email, the email is so stupid. That You have to figure it out. It only can time sort the order. It doesn't know what's important, and then you have your messages And you have to go back and forth and you're the one who puts it little folders and things. I mean, the I thought the semantic level of interaction with the computer

would be higher by now, even without AI. But now with AI The idea that it Yeah. very high level tasks that I'm doing you know, I'm working on my budget, I'm considering buying a new home, that it will be working with you, not at the spreadsheet cell level.

But at the O Uh, you know, let's break this task down in in a high level form. Here's what I can automatically go and And do for you it's in a super revolutionary You know, we'll all have an agent.

That is a utilitarian, help you get things done. You know it reads everything you read, but The Things you meant to read. Uh it reads uh

And then you know, you'd you'd Your agent can figure out okay which parts of that Our important enough to

To take your time to understand. We are now switching to rapid fire. I'll let Reed ask the first question. Is there a movie, song, or book? That fills you with optimism. For the future.

Well, the better angels of our nature, Stephen Pinker sort of documents how Violent death, you know, lifespan, education. Have gone. And you know, there's some lessons of

why we've done well doesn't guarantee And he doesn't say. That's That's the future, but You know, if you have one book which should

get you back into the mindset of okay, how far have we come? What should we feel good about? I'd I'd recommend that one. Fabulous. And uh what is a question that you wish people asked you more often? How does malnutrition work? Uh you know. are boring and we should solve without most people having the Ever figure out

Toilets and nuclear reactors and Um You know, yeah understanding Disease I'm surprised people aren't more curious, you know, when I first said

What do kids die of? I had a hard time finding out and I would have thought Bon. Isn't shouldn't we all be ask that kind of thing? Uh it's more important than GDP. Exactly. I love it. Um so where do you see progress or momentum outside of your industry? Of course, that's very broad.

That inspires you. But when India's an example of a country where oh there's plenty of things That are Difficult there.

the health, nutrition, education is improving and they're stable enough and generating their own government revenue enough. Yeah. It's very likely That

Tin years from now, people will be dramatically better off. And it's kind of a laboratory to try things But then when she proved them out in India, you can take to other places. And so Our

Biggest non US office for the foundation is in is in India and then most number of pilot roll out Things we're doing anywhere in the world or with Partners. In India.

You know, if you go there and you've never been, you might think, Whoa this is a chaotic place. Uh and You know, you're not used to so many levels of income all being on the street. at at the same time, but you you will get a sense of the vibrancy. Mm-hmm. All right, last question. Can you leave us with a final thought?

About what is possible to achieve if everything breaks our way. In the next fifteen years and and what's the first step to get there? The potential positive path is so good. That it will force us to rethink. How should we use our time?

You know, you can almost call it a new religion or a new philosophy. Of Okay, how do we Stay connected with each other, not addicted to these things that'll make video games look like

Uh nothing in terms of the attractiveness of uh spending time on them. So it's fascinating that we will The issues of you know, disease and enough food of climate.

If things go well. Those will largely Become Solved problems. And

Yeah, so The next generation Does get to say okay. given that some things that were massively in shortage are now not. How do how do we take advantage of that? You know, do we

Ban AI being used in certain endeavors so that humans get Uh some You know? You know, like you you don't want robots playing baseball probably. Uh'cause they're they'll be too good. So we'll we'll keep them off. Uh the field, okay, how broadly

Would you go with that? We are so used to this shortage world. Yeah. Іно, аппаюсі хай старт то рет. Uh

These Deep meaning questions. Bill A Tour de Force. Thank you. Yeah, great talking to you.

Possible. is produced by Wonder Media Network. It's hosted by RA Finger and me, Reed Hoffman. Our show runner is Sean Young. Possible.

It's produced by Katie Sanders, E.D. Allard. Sarah Schleed. Adrian Bain And Paloma Moreno Jimenez.

Jenny Kaplan is our executive producer and editor. Special thanks to Soria Yalamanchili, Saida Sapieva, Ian Alice, Greg Biato. Parth Patill and Ben Rallis. And a big thanks to Aubrey Bogdanovich, Ian Saunders, Christy Anthony, Alex Reed. Jen Crajisak.

David Sanger. Larry Cohen, Alicia Salmond. Sean Simons Denali Weerman. Andrea Dramer, John Ryder

the whole team at Gates Ventures and Little Monster Media Company. Hey listeners, Bob here. If you listen to Rapid Response on Masters of Scale, you may be missing half the show because every Friday we release a second Rapid Response exclusively in the Rapid Response feed. The guests and topics are just as compelling and timely. From Ford CEO to NASA's administrator to the lessons from The Devil Wears Prada. It takes about 10 seconds to find, just search rapid response wherever you listen to podcasts and hit follow to make sure you never miss an episode. I hope to see you there.

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