by Ardian Wibisono
Despite holding an event on a Saturday, more than 50 media showed up for the launching of the Indonesia Health Fund, along with over 100 VIP guests. Why? Maybe it was to see Bill Gates, the world’s richest man ($72 billion) and the co-chair of the Bill and Melinda Gates Foundation (Melinda being the other chair). He was making a rare stop in Jakarta to witness the signing ceremony that was bringing a new model of fundraising to his global philanthropy. Although Bill had been in Indonesia before during his Microsoft days, this was his first-ever visit in his new role at the Foundation. The venue in the Shangri-La hotel had been originally set for about 70, but had to be expanded to 100 to accommodate the extra guests. Even then, many had to stand in the back after all the seats were filled. Among the high-level tycoons in attendance were Boenjamin Setiawan, The Ning King and Murdaya Poo. Including the eight Indonesian donors to the health fund, the personal net worth in the room easily exceeded $25 billion, not including Bill, who was coming because of his relationship with billionaire tycoon Dr. Tahir (who is the majority owner of the Forbes Indonesia license).
Exactly on schedule and to a round of applause, Bill entered the room with Coordinating Minister for the People’s Welfare Agung Laksono and Health Minister Nafsiah Mboi. While Agung made his welcoming remarks in Indonesian, Nafsiah discreetly leaned over and translated for Bill.
The day’s event set several milestones. First of all, Tahir had organized eight donors to each give $5 million over five years ($1 million per year) to the newly launched Indonesia Health Fund, for a total of $40 million—which the Bill and Melinda Gates Foundation matched dollar for dollar, for a total of $80 million. This model of a group donation had never been done before in an emerging nation for the Gates Foundation (before it had always been individuals donations). The bulk of this money, $60 million, will be spent in Indonesia, to fight tuberculosis, malaria and AIDS and promote family planning. The remainder will go to fight polio on a global basis. With $60 million the Indonesia Health Fund instantly became one of the largest philanthropies in the country, ranked on size of funds.
Just as remarkable was the speed by which this event came to fruition. It took Tahir only one year after he himself pledged his own money to the Foundation to organize this group donation—the original idea was his but developed over the year in dialogue with the Bill and the Gates Foundation. The $40 million was just a start, Tahir would like to raise that to a total of $100 million (with perhaps 20 donors giving $5 million as a model). “I think Indonesia is setting a new example,” Bill said in his remarks at the event.
For Tahir, helping out the country was an easy decision. “I have thought a lot on what should I do in the coming days of my life. Mr. Gates has changed my life. For the past year, I have learned to be active and disciplined in participating in philanthropy,” Tahir said at the event. Last year Tahir also signed Bill’s Giving Pledge, making him among 121 others who have committed to giving a bulk of their wealth to a philanthropic cause within their lifetimes.
The money raised at the day’s event will go to the Global Fund, chaired by Nafsiah in a global role. This Switzerland based fund is the world’s largest private donor fund, disbursing over $4 billion, with Indonesia as one of the largest recipient countries. In April last year, Tahir signed a $200 million partnership with Gates, with each donating $100 million. The partnership represented the Gates Foundation’s first major private donor partnership in Indonesia. The donation also made Tahir the second largest donor in the world to the Global Fund after Bill himself.
Christoph Benn, director of external relations at the Global Fund, explains that the funds raised for Indonesia will mainly be used to buy diagnostic tools that can quickly and accurately diagnose TB. With a highly infectious disease like TB, reducing the time gap between the outbreak of symptoms and the diagnosis can greatly reduce its spread. “Normally we get the resources from rich countries. This is the first time we have a wealthy individual from a country that is receiving money taking part. This example could be replicated in other countries in Asia or elsewhere,” Christoph says.
Partners in Health
Moving from businessman to a full time global philanthropist means Bill is as busy as ever. Arriving from Paris, Bill in the course of one day in Indonesia traveled first to Yogyakarta in the morning to visit a health clinic at Gadjah Mada University, then arrived around noon to Jakarta for a signing ceremony for the Indonesia Health Fund in the afternoon, followed by private meetings, before flying to Singapore in the evening where the next day was another round of high level events including witnessing the launch of a similar initiative for Vietnam. In the middle of this busy schedule, Bill granted Forbes Indonesia his only exclusive print interview. Wearing a brown suit with no tie—the day’s dress code—Bill was joined by Tahir. The interview was held in a private boardroom in the Shangri-La, where Bill ignored a large meeting table and did the interview in chairs set in an open circle to make the event more casual. The interview with Bill and Tahir covered a wide range of topics on philanthropy.
FORBES INDONESIA: In U.S and Europe philanthropy is quite developed yet here in Asia it’s just starting, what is your vision of where Asia should be five years from now?
BILL GATES: The U.S., which is the strongest in this sector, is probably a good example for other countries. The government is super important, but it can’t solve all the problems because it’s not going to try new things like inventing new drugs or new ways of delivery, and it’s not going to take risks as a philanthropist can. When people have success and choose that some of that should go back to society, it can be fulfilling for them, and they can use their skills and connections.
So, for Indonesia, it’s fantastic that you have Dr. Tahir’s understanding, capabilities and resources. His friends and colleagues who joined him are going to be engaged in deciding what’s working and what’s not, even to be a voice on government health policies. Having the philanthropic sector keeps the successful part of society engaged with the part that’s not doing as well. I’m spreading the word that I’m enjoying it and finding it fun.
Many people think that it’ll be too vague to see what you’ll be getting done. In business, you see products selling and profits measured as feedback. If you do philanthropy right, you can get much of that feedback including things that don’t work.
TAHIR: The people that signed the commitment today have done much individually but not on a regular basis. This time the Gates Foundation approached us and said this is something that you will have to commit to, with discipline and focus. It’s new for us and we can learn from it. There are many things that the government cannot do in the health sector and I feel great to be able to participate. I agree that if we look at it in the right way, philanthropy is enjoyable, because you can do many things for those in need.
FI: What is the best way to do philanthropy? Does it need to be through a large foundation like the Gates Foundation or can it still be done on an individual basis?
BG: Ideally, philanthropy is for both the very successful people and society at large. You can give money, your time, your political voice, and all of these things are quite important. So we hope that people at all levels of wealth are drawn into it. In my case, because of the scale of resources and the ambitions about these diseases, we’ve built an institution of 1,200 people and assembled a lot of experts to make drugs and vaccines. My friend Warren Buffet decided that he would take advantage of what we’ve built and simply give us that extra capacity. It really depends on identifying the best way to do things. There are philanthropists who pick sophisticated recipients like the Global Fund because that they do not want staff and a lot of people prefer it that way.
FI: Towards the end of your presentation, you mentioned that Indonesia can serve as a model for other countries. Could you elaborate more on that?
BG: Philanthropy can make a huge difference, by showing governments by doing pilot programs. The goal would be to make it a bit larger and a bit more measured and systematic. So for example in India, the Tata family started doing philanthropy in 1910, three years before Rockefeller gave his big gift. Azim Premji, who is on a Forbes list, also does philanthropy. So you do see the beginning of a bit more ambitious, measured philanthropy.
In particular, what happened here where people at a younger age were brought in to think how to help those most in need in Indonesia is pretty novel and I’m thinking how I can do this in India. Could this work in China? China is always a special case. Drawing people into these high impact causes would be helpful and I wouldn’t have been that ambitious unless Dr. Tahir had shown me that this could happen.
FI: What do you foresee as your biggest challenge as a philanthropist here?
BG: Indonesia’s done quite a few things well, and yet the vaccination rate is not as high as it should be. It should be 95% and now it’s more like 65%. Indonesia can learn from good examples too, like Vietnam which is poor but when it comes to running a primary healthcare system and vaccination for every child, is even better than the U.S. Vietnam achieved over 95% coverage on its vaccines. It is very systematic and when you go to primary healthcare centers, you’ll see a list of all the pregnant women and the expected birth date and it’s not even a digital system. I think there will be steady progress here, yet this requires putting more measurement systems in place.
Partnering with the government and the health minister here has been quite good, that was why she was picked to chair the Global Fund. She’s doing a good job on crafting the right way to work with the government so that we’re helpful and that we’re doing things that they wouldn’t otherwise do. We do things in a way that the government can take over after the pilot project’s done.
FI: What has the impact been so far of the Gates Foundation effort?
BG: The thing that we’re most proud of is getting new vaccines out. I mentioned rotavirus, it’s being rolled out to children most in need and within five years all children in the world will be getting the vaccines. All countries will be adopting rotavirus as one of the vaccines they deliver at a very young age. Our partners in this vaccine line, GAVI Alliance and the Global Fund, have saved millions of lives.
We’ve put substantial resources into them because they fulfill a role in getting medicines to everyone with HIV, tuberculosis and malaria. They’re quite efficient, raising money both from philanthropists and the government. They’ve negotiated lower prices because they’re buying large volumes for the poorest in the world. They find the cost to make things and then negotiate the lowest price as possible.
That is why it’s good having companies like [Indonesia’s] Biofarma more involved not in just making vaccines for Indonesia, but also for the world. They’ve already done that for the polio vaccine that’s now used globally. There was a crisis with the polio vaccine a decade ago where some people in Nigeria were claiming that it was not pure. Biofarma pointed out that the company is making it in a Muslim country and was very careful. It was great seeing how Biofarma could ensure that it was pure and of course it was.
The Global Fund and GAVI are the two things that we highlight. So if you look a few years ahead, hopefully polio eradication will join that list and contraception too. My wife wants part of our goals to include that any woman who wants contraception should have access and a variety of choices.
FI: You noted earlier that one of the donors was relatively young, and to ensure long-term sustainability, a new generation has to enter the philanthropic world. So how does one get younger donors engaged?
BG: A lot of habits are formed at a very young age and by what your parents do. I was in a family that did some philanthropy, not at a large scale, so it became obvious that when I got successful that was something important to do. I did my biggest gift to the foundation in my late 40s and I switched to being full time on the foundation when I was 52. I thought I was going to wait until I was in my 60s. But after working part time in philanthropy, I could see that it might be more fulfilling so I accelerated that.
Mark Zuckerberg has been doing some philanthropy even in his 20s, and that’s good for philanthropy if younger people can understand the value of this. So we want to diversify and certainly we want people to give while they’re very capable, not when you’re in your last few months of your life and whoever is beside your bed is telling you to sign something. You can’t enjoy it as much if you’re trying to squeeze it into those last few years. For me, what has made the transition from Microsoft to the foundation smoother is that I’ve done it part time. If I’d done it from zero, it might have been really frustrating.
FI: How do you see the current state of development of philanthropy in Asian countries?
BG: Every country is different and the two that I know best are India and China where philanthropy is on the rise, but not at U.S levels. In China, the fortunes are first generation fortunes where there is a higher tendency to be philanthropic than if it’s been passed down for a long time. Talking to many Chinese tech leaders, they’re thinking about philanthropy and we want to get people in all sectors involved in this.
I do an annual event where Indian philanthropists get together and talk about things and more people have been showing up to that, and there are more examples of people giving there. Japan is another country that I’ve been to a lot, but I don’t see much change. Down in Australia, I’ve talked to some people like Andrew Forrest, who are very vocal about anti-slavery.
Dr. Tahir and I are going to Singapore and we’re doing a Vietnamese health fund modeled on what was announced today. The commitment there is $50 million, which is not as big as here, but the economy and population is much smaller than in Indonesia. So when you ask me where there will be a group of philanthropists getting together to do global health work, the first two are Indonesia and Vietnam.
FI: Is that one of the new aspects—that philanthropy is becoming more global?
BG: Hopefully here, we’ll get the best of global and local. Most of the resources and expenses spent here in Indonesia will be based on the global expertise of the Global Fund that we’ve assembled. So for example, the polio campaign that I spent most of my time on is a very sophisticated operation in its delivery and measurement. It took incredible sophistication to finish India, which had its last polio case in 2011, and we’re taking the lessons from that to other places. It is not just a global pool of money, but a global pool of expertise.
I love this idea that you take the very best health behavior and apply it anywhere in the world, just as happened in Vietnam. There are actually a few health things the U.S. does well, not many, but a few. We do the science, creating new medicines and vaccines. The depth of knowledge is strong in Boston and Silicon Valley, both in large and small companies, so innovation is powerful there.
China has done some things well, however it has not done well in tuberculosis and tobacco. So what Indonesia could do better on—pretty high on the list is tuberculosis, which is where a lot of this money raised today will go to. We were talking to the health minister, encouraging her to put more into tobacco legislation. She’s good on that, but she’s got a lot of opposition. We’re asking her if our voices could be helpful.
FI: Dr. Tahir, could you please share your impression on philanthropy in Indonesia?
TAHIR: In the old days under President Suharto, businessmen, especially the ethnic Chinese businessmen, treated philanthropic donations as a political cost. But after the democratic reformation we want something to be achieved with these philanthropic works, and to see where the money is being used. Today I convinced all these businessmen to give back to the country through a clear system, which is accountable, sustainable, and very focused. We asked the Global Fund to explain to them that its system is right, with an audit report and other measures. I went there myself to see the health facilities in Bandung and with Mr. Gates’ visit, I hope we can will inspire more donors. I am confident a lot more will come.
FI: Now that polio is almost eradicated, could this happen with the other diseases?
BG: The goal for these diseases is eradication, but you have to be careful. You can end up spending a lot of resources and if you don’t succeed then it’s a misallocation. Right now the only main disease in the eradication plan is polio. But we are doing some pilot programs on local malaria eradication—for example, there are some in Cambodia and Thailand over the next five years. The goal is to eradicate polio by 2018 and by 2019 declare a plan for malaria Eradication.
For tuberculosis, we need to push the number down. The deaths have gone down but the prevalence of the disease has not. Indonesia faces the same problems as in India. A patient can take a long time going to doctors who aren’t very good on tuberculosis until they finally end up where they get properly diagnosed and treated. Figuring out how to get part of the private sector into high quality tuberculosis work is part of the solution. But that will just get the numbers down, it will not achieve full eradication.
In my lifetime, I hope we can eradicate these diseases. But we need to maintain the credibility of the effort by not overpromising what we can do. Ironically, malaria eradication was declared many times and failed.