system that huge? i go back to the fact that there is a team that is going to be involved in this process. we need to keep the team working together the best they can. with the national commander of the american legion, today at 6:00 p.m. eastern on c-span. microsoft cofounder bill gates had a meeting last week with president trump to discuss u.s. foreign-policy. prior to that meeting he sat down for an interview with politico. it is about 45 minutes. [applause] >> thanks so much. mr. gates: thank you. >> thank you so much for being here today. we are excited to kick off the conversation.

why don't we just take a step back about what you're doing here, what your message is. >> why are you here? [laughter] >> what is the message you are bringing to washington on this trip. mr. gates: my full-time work at the gates foundation, we have two big things we focus on. one is u.s. education. the other is global health. the u.s. government is a key partner in both of those activities. in the case of health work for all the diseases, the nih is either the biggest funder or the second-biggest funder. we are either the first or second biggest funder. in making sure that research is making progress, understanding how we can work together better. in terms of foreign aid, the overall foreign aid, the u.s. is the biggest single country. about $30 billion of that. as a percentage of the economy, it's lower than some others. some europeans are above 1%,

like germany and the u.k.. but it is a huge pool of resources. our foundation is about $5 billion a year. we need to partner up with all the donors to go after things like polio eradication. the program on hiv is absolutely miraculous in terms of holding that disease in check for us to get a vaccine. a lot of the discussion is about the money allocated to these things or with the executive branch on the execution of these things. i am back your four times a year. when the white house daily guidance came out last night, we learned that you are visiting the president today. talk about your experience with the president and what your message is going into the white house. >> this is a fairly interesting time.

budget wise, it is interesting, because since there was a demand to get the defense budget up and a demand that the nondefense not be too far behind, the defense overall will be making a 12% increase, assuming the omnibus passives -- passes without some big change. that is pretty unusual. >> more spending than almost any time in the last decade. mr. gates: and more than there is likely to be in future decades. in the discussion about of that 12% increase, what are the problems. this is a serious amount of money. hundred and $43 billion a year is 30 times great -- a hundred

$43 billion a year is 30 times greater than what the foundation gets. the idea of where should that go . into transport, and education hearing how people are thinking about that. where does the decision to break down get made. what are the best ideas from various political groups? the good news for the area of greatest concern for us is about foreign age, the foreign aid budget means that for two years the normal discussion about where does this really go and is in some of this not spent perfectly? can someone else just do this for us? .hat challenge will be far less

often when i come here it is because i get to go to africa and see initiatives at work. i can come back and. often when say we are measuring this, here is how we improve it. there is a huge benefit to the u.s. in terms of having a stable africa. measurementt the way that we make sure the money that we are spending together with the u.s. government, that we make sure that is as best as it can be. >> you alluded to this. in one week, the budget needs to be pastorals the government will shut down. if you could wave a wand and get one or two things done or get congress to do one or two things, what would it be? mr. gates: it is important to remember you can't wave a wand. congress allocates money and

makes policies. the private sector and science deliver most of the miracles. and those need to go together. the internet was funded by the department of defense. most of the great biological advances that have been made are so generous with the mih. if you compare globally, way over half the money is discovering how to cure cancer, is spent here in the united states. it is win-win. we get the companies because the people involved in the research go and build the products. if i had a wand i would waive it to create magic clean energy that is cheap or to take the work we are doing on malnutrition, which is a great

problem, and let's understand and get rid of malnutrition. congress is super important. the miracles require the hands-on private sector piece as well. >> when you think about your meeting with the president, what is the best case scenario coming out of it? mr. gates: two clear messages. one is about foreign aid. we are partnered with the government. even if you just look at the benefit to america, stability and disease being the most -- being less likely to come here, that this is very beneficial. having those strong relationships, maintaining that commitment, continuing to tune

it. there are great things that are coming out of that. that has been my primary message. the cousin of this budget increase, a second message -- because of this budget increase, a second message will be there is an opportunity to take on these problems. one i would highlight is the preparedness we have for a , unnatural pandemic or an intentional -- either a natural pandemic or an intentional pandemic. we do not have the tools to deal with that. point where to the for a fairly small portion of percentrease, say a few a year, you can do something quite miraculous in terms of health security. there are specific ways -- this one is complicated because the civilian side and the defense

side both need to work together to achieve that. does the if he can get excited about that as something to prioritize with the new spending. >> the president has said -- has tweeted and said in other settings that foreign aid is the cause of our budget deficit and the country spends way too much helping other countries and it is time to start helping our country. that is the message the president has said multiple times at multiple venues. react to that. how do you get a president who is allergic to some of these ideas? foreign aid is so obscure, if people bring it up, even in the negative sense, at least people are bringing it up. we have a chance to explain to people that it is less than 1% of the u.s. budget.

youn if you hear that word do not connect it with saving lives with hiv medication. this president bush, program, which if you had the -- if youe stopped explain that to him, should we continue to save those lives so that that disease does not get out of control until we get a vaccine, which then will enable us to end the hiv epidemic. we stop a lot of people that need treatment. put like that, people respond positively. if people could go on trips with me and see these things. mr. gates: you could it -- >> you could have asked us. mr. gates: there are a lot more voters than seats on my plane.

congress toers of go visit and see that work, people like lindsey graham are very active in getting his colleagues to go out and learn and see. that is partly why many elements of foreign aid, particularly -- has continued to have the strong response. that did not stop an executive budget proposal from including potential cuts. in that case, the congress did not consider seriously cutting that money because they did not have a commitment to it great >> are you concerned about the america first rhetoric? it is anathema to what your whole mission is these days. mr. gates: i don't agree with the american first rhetoric. i think the alliances we have built over time and the help we are provided countries, starting

with the marshall plan, our role in supporting the united nations, the bilateral things we do, we have made the world a more stable place. i think that is good from a pure humanitarian point of view. , think that foreign aid because the budget is so small, we pick things that are so effective that even if it benefits americans, americans do not want have pandemics and send soldiers to create stability in africa. look at our ratio. we spend over $600 billion a year on defense and $30 billion a year on foreign aid budget. that is a 20 to one ratio. for european countries, the ratio is pretty close. three to one. we are a hard power country. president bush was thinking we

will exercise hard power and wanted to make sure that the soft power peace was made stronger as well. mattis saideneral the foreign aid budget helps. if you cut it, you have to give him more money for weapons. i am a huge believer that the framework does not say we should cut the money. >> when donald trump ran for the presidency, he talked about being a businessman. that is why he was elected. in your experience running businesses, do you feel like there's a good sense of how he thinks? and has everybody you met in

your time and your career prepared you to deal with somebody like him? [laughter] mr. gates: in business, you meet a lot of different kinds of people. [laughter] and you have to be good at adapting to different styles of working. i wasn't in the new york real estate business or the new jersey casino business. it is a whole different approach, but you know, you find things in common. and i think president trump would like to take some of this new money and have something that's new and makes a big difference that he is personally exercising leadership against that. everyone should be creative about what can be taken to him that would fit that and serve

the country's interest, and really resonate. particularly if it is something were presidential leadership would be important to make it happen. want -- >> people are fascinated by you. we have more interest in this event than any event we have ever had. >> they are not here for us. >> take a step back. walk us through a day in the life of bill gates. mr. gates: well, the foundation shapes most of my time. i spend about 10% of my time over at microsoft, had a board meeting on monday and tuesday. i get to help shape some of the strategies there. i thrive there, maybe two or three days a month. i do some things outside the

foundation in terms of the science investing. i do a ton of work on clean energy, iva nuclear fission company and a bunch of energy related things. breakthrough energy ventures that is over a billion dollars that people of paid together to finance breakthroughs in clean energy. most of my time is at the foundation. had two weeks of strategy reviews where we go through all the things we're doing, what is going well, what is not going well. we do malaria, hiv, tb. we do the u.s. program that has k-12 and higher education are the key components there. i travel a lot. i need to get a africa three or four times a year. next week i will be in chad and .igeria the entire week i spent a quarter of the -- i

spend a lot of time and nigeria because it is a quarter of the population of sub-saharan africa. i will be over there. a lot of the trips are two other , the u.k. ands germany give more than half of what the u.s. does. even though their population economy is dramatically smallerd , talking to them about joint work. polio eradication is the single biggest project that i put time and on because we are in a very we have phase where three countries, nigeria, afghanistan, and pakistan. the only countries that have had poliovirus in the last three years. if we execute well and have a little bit of luck, this will be the last year that any child ever gets paralyzed with polio. [applause]

>> we asked some of our readers to send us questions. we won't give you all of them. one that was very interesting is how do you decide what areas to fund? this is from a reader who said malaria, tb, and polio are three things you've worked to eradicate. there are other diseases like , how do you -- take us through your thought process. and i pickedlinda the two areas we were going to work in based on our values. nobody can work on all the areas. u.s. education in global health.

once we pick global health, then within that, we are extremely about saying, ok, of this money, what can have the highest impact. and we can save a life for less than $1000 a life saved. it's at the bar. if someone suggests we should work on cancer because you can do something. the pharmaceutical companies with the r&d budget 20 times bigger than ours, they are working hard on that. the incremental benefit of any new advance their is -- a new there is in the $400,000 per life saved regime. going out and getting more measles vaccines is more $1000 per life saved.

working on infectious diseases, things like very cheap drugs and where vaccines can be invented and gotten out to people. -- when we metric got started, over 10 million under the age of 10 died per year. that has now been cut in half. it is under 5 million per year. that is because of what we and our partners have done with vaccines and improving the primary health care system and getting malaria nets out. by 2030, we will have cut that in half again. it will go from 5 million year to 2.5 million year. huge progress in a dramatic way. diseases that are very rare, we will not work on.

we have made so much progress on ,he big ones, we just funded friedman to go out and look at heart disease and hype blood pressure in africa. sickle cell was not a focus for us but now it might be if we can figure out the right treatment or new inventions that can help out with that. it is about 2% of the deaths in nigeria are specifically due to sickle cell. we fund a group called the international health metrics. to me at the university of it is aboutwashington, where the understanding of what people buy right,etting the numbers is 100 times better today than one -- then when we got started.

we even have to do things that are hard. no it -- no autopsies are done for these children who died. we created a thing called a minimally invasive autopsy were we can take a few samples and have it analyzed. we can get a picture of what we need to do to save these lives. >> we should kick it out one of our reporters. i do not know where they are sitting. >> she covers the state department for us. >> thank you so much for being here today. i cover foreign policy for politico. my question is this -- one of the reasons the trump administration gives in wanting to cut foreign aid budget is they feel like other countries are not doing their fair share. they call this burden sharing. they say the u.s. gives more than it should and it is making other countries dependent on us. you mentioned that some countries have smaller populations but do give significant amounts. isn't then is

the kind of shock therapy that other countries need to step up and give more and be less dependent on u.s. aid? >> the figure of merit is what percentage of your gdp do you give as foreign aid? norway is 1.1%, sweden is 1%, the u.k. is .7%. germany is .7%. we are .22%. we are substantially less generous than those countries are. , notu like shock therapy getting hiv drugs is a form of shock. you die. those people no longer need foreign aid because they will be

dead. i do not get the logic of why that would be a smart thing to do. the story of foreign aid as you allow countries to lift themselves up so they become self-sufficient. aid the u.s. started giving after world war ii, a lot of that aid went to redevelop europe, some to develop japan. by the time you get to the 1960's, you have a bifurcated world, where you have rich countries and poor countries and almost nothing in the middle. partly because of aid and partly because of scientist -- science and economic development, a miracle took place. today, most people live in middle income countries. brazil, mexico, and fairly soon india, china. the bulk of the 7 billion people live in those middle income

countries that are not substantial sources of aid or substantial recipients of aid. low incomeave countries and those countries, in order to get stability, help, education right so they have their own domestic tax collection, they need foreign aid. when you have malaria, when you have an hiv epidemic, there is no source of revenue that is going to let you buy those hiv medicines or those malaria nets. the research to create a malaria vaccine, who should do that? and the expertise are not in those poor countries. when we gave our first grant for a malaria vaccine we became the biggest funder. the market is not going to provide it. in terms of humanity, it is still killing.

of progress.a lot it still kills half a million kids a year. if i told you there were two kids dying in this audience could save those two kids, i think people would respond. it costs $14 per bed net. did we manage $28 to help those two kids? those kids would be dependent on us. that would be awful. they would not die of malaria but they would be dependent on us. it is hard for me to understand the notion that helping people poor then we are is a bad thing. it is kind of in the bible. [laughter] partnersms of finding you are often butting heads with the government at microsoft. now so much of your time is spent trying to get countries to give more money, doing this

diplomacy effort. have you had to reshape your framework of where government should be involved? government is a two thingshing for -- justice and military. it is true microsoft had this long doj lawsuit. trotting by the district court where i got onto the sidewalk and say that was a good day in court even when it was not. these days are probably more fulfilling than those days. mr. gates: i enjoy that. the doj lawsuit was not a positive thing, but i loved my time at microsoft. treat governments, including the u.s. government, they treat me nicer as a fuller

a floor -- as a philanthropist than they did is that capitalist. a capitalist before you become a philanthropist. mr. gates: it helps. otherwise you will not be a large philanthropist. that affects the impact. you could say it is ironic because we started the foundation, i thought our primary role would be the invention of the new tools. that is a little over half of what we do. the hiv vaccine, the tb vaccine. all of those things. the idea that we would have to get involved in the delivery to go in and help improve the primary health care system, partner with the government of ethiopia to look at where do you put your health clinics, how you measure their work? i do not know that was going to be necessary.

i thought that if the right things were invented and the demand was there other people make sure they got out there. it turned out that was not realistic. there were actually fairly good tools that had been invented. there was a vaccine called rotavirus for diarrhea which was given to the kids who did not need it. rich kids never die of rotavirus. time, overt that 500,000 a year, or dying of rotavirus. those poor kids were not getting that vaccine. that vaccine, if you make the right guarantee, it is about three dollars for a full dose of that vaccine. now, that is one of our great achievements. now virtually every child in the world is getting the rotavirus vaccine. that is an element from how we went to 10 million year dying down to 5 million year.

it has been 15 years since the program that is been effective passed congress in a -- in a verye way bipartisan way. i wonder now, when you encounter when you try to build new allies on capitol hill. you went to shake shack yesterday. >> the shake shack summit. >> tell us what you encounter and do you sense resistance? how you pick your allies. >> the next generation, if you will. >> lindsey graham and john mccain are champions of some of these causes, but they are veteran lawmakers. how to go about finding these folks and convincing them foreign aid and global health are important priorities? mr. gates: our team, led by rob

neighbors, is reaching out. isgo to every member and say foreign aid something you would like to learn about? our view is the more you learn about this, the more you realize this is real. this is pretty important stuff. icon, a melinda and fair portion of the time is sitting down and talking about the progress and hearing what concerns they might have. peopleably more focus on on state in foreign committees. we do not limit ourselves to that because the simple ideas about foreign aid -- we want to rebut those. even the press coverage of foreign aid, oxfam had a scandal

which was awful recently, the good news does not travel quite as fast as the bad news. trying to make sure people have an overall picture that some things are not manage that well, but overall, whether it is health or education or thisultural or sanitation, time has been the best ever and helping poor countries uplift themselves. >> we have a question from a reporter in the audience. >> good morning. facebook, twitter, and google have faced harsh criticism for what is seen as allowing their platforms for getting out of control. one symptom is russia's efforts to influence american domestic politics. you mentioned some experience with government oversight. do you think the government needs to step in, if not, why not, and if so what would that look like? interest in do

these platforms polarize people exacerbates, trends towards polarization that is already taking place? do they allow foreign influence that should not be allowed, trolls, hate speech, to come on and affect people's views. those are interesting questions in a democracy. in the world of media there have always been government rules about how media is used politically. have a desire to say these platforms need to do something different, let's take facebook in particular, the specific recommendations about what they should do i find vague. of, is there an exact line where free speech stops and

hate speech starts? and what is it that foreigners are allowed to say? foreigners can go on to these forms and talk. you're probably not have only u.s. citizens talking to each other. when does it become a form of political influence. what type of visibility should have. there were draft bills that would have created huge transparency about who is buying ads on these platforms. they did not choose to move those bills forward. there is definitely something that needs to be looked at. solutions are a little less clear. >> what do you hear from foreign leaders about the united states at this moment?

the world ise way benefited from u.s. leadership is hard to overstate. most of their policies, they will say what did the u.s. do? how did the u.s. debt great universities? how did the u.s. organize research? even on an issue like what we do to prepare for a pandemic. the cdc is by far the best in the world at what they do. it is phenomenal. the u.n. system has benefited not only from the resources but the personnel that go there. people from the cdc are working at the world health organization , really professionalizing it, helping that organization work well. there is an expectation that the u.s. cares about world stability and world progress. as we surprise people and start to pull back from those things

or we say that our role in those things will have a short-term inus on our sole benefit those activities as opposed to for all of theit different members, that is potentially a problem. it creates a vacuum of leadership that people badly messed. when you ask them if you love the united states, they will say -- there is this dominant they are a dominant country that does not do something well, they get involved in things they should not, they do not get involved in things they should, everyone has an opinion about how the world's leader goes about exercising its leadership. as that engagement has gone down a lot of these forums, i think people are very must missing it

-- are very much missing it. >> there is new leadership at the state department with mike pompeo coming in as head of the agency. do you know him? will you work with him? do you think it is important to have that sort of stable top diplomat for this country? mr. gates: we always work with the secretary of state. we have mark green, the administrator over at usaid. we work very intensely with usaid. coordinator, as lot of that money is going out to usaid. there is a deep collaboration there. andhe hiring of good people more out the state department can be improved under new leadership, that will be a good thing. i will certainly meet the new secretary and talk about the partnerships we have had and how we can manage those. we have not talked

about is a new interest of yours, a new priority. alzheimer's. a lot of your work is abroad so it doesn't touch the u.s. as much as it does and perhaps sub-saharan africa. talk about what you are doing on alzheimer's and how you think you gallup big impact. -- how you think you can have a big impact. mr. gates: for the foundation, a big part of our work in the u.s. is education. alzheimer's is unusual because there is a gigantic market. whoever creates a job that jurors alzheimer's will make billions and billions of dollars. it is a target that has proven to be very difficult. it is the disease there been more failed trials on than any these are very extensive trials. the gold standard is improving

behavior on a cognition task. in some cases, six to eight years. the early trials probably recruited patients that were too far along in their disease for the drug to have the benefit. this is a disease were getting the drug up to the brain, that is very, very difficult. the human cost an economic cost alzheimer's is gigantic. a lot about liability for long-term care will fall on the government. we are very generous compared to any other country, our investment in solving this problem at a research level has not been enough. the congress, with a few people being very active, has taken that budget, the mia budget --

from 400t has gone million. under the proposed budget is likely to get up to 2 billion. it is the fast growth that the national cancer institute had at the beginning of the war on cancer. it is a fantastic thing. my role, in terms of saying this requires a lotat of different actors to come in. my goal is funding people for a biomarker. there is a lot of international data, government data that is not available to research. they can learn about disease progression. that is something we have done in the foundation of how young children grow. doing that type of database goes back to my background in

microsoft of how you empower researchers. a few things, including in investing in early-stage try risk companies, they have new approaches. approaches, those are the drug trials that have not worked out. you aboutnt to ask education, since that is a focus of yours. secretary betsy devos has made a lot of tank -- a lot of changes that are not in line with your foundation priorities. what is your reaction and how concerned? >> and did you watch on 60 minutes? mr. gates: no, i read articles about it. , the federal government under the obama administration and bush administration was very active in trying to say, how do we manage teachers? are we looking at how they are

achieving things? are we getting feedback to them? ok, theredone to say, government has some ideas about what we could do to change that. ,nce we got the reauthorization the role of the federal government was greatly reduced. k-12, most of what counts is at the state or district levels. there have not been, under this administration, there have been slight tweaks here and there, but there have not been a dramatic set of changes to the money or the overall emblem of money. even in the areas they have talked about, the idea of school choice, there is a bit of that that we agree with that have shrunk charters and try that out. that could be very positive.

we are never going to have more than 10% of kids in charters. even if you do the best job possible on charters, you have to use that as a learning lab for the 90% who are not going to be in charters. we are in a lot of states now partnering and china have new things. foundation ied the thought -- would be the hard thing and we would make little progress. we would have very quick wins in u.s. education. maybe move the map 5% -- math 5% and the reading scores 10%. really get that to build our confidence so we can do -- go to nigeria on a regular basis. every school where we have gotten involved, whether public or charter, great things have happened.

but when it comes to taking that and scaling it off and getting orer schools to adopt it, even the schools we are in. say it is three years after we have been there, does it present -- does it persist or does it go away. we feel good about the direct intervention. k-12, 600nthropy in billion a year being spent in that market. all you are doing is pilot programming type things. if you want to move the macro statistics you have to figure out, not only good ideas that work or good ideas that get massive. dash -- massive adoption. did is we gotwe people really topping -- talking

about the dropout rate. ninth-gradeing class and graduating class. up until then people just talked about entering senior class. most of the dropout takes place in the first three years. people paid attention to that. that dropout member has gone down, but it is nothing like what we have achieved. are just about out of time. it has been a fascinating conversation. we do expect you can move president trump off of his america first rhetoric? mr. gates: no, i will take his framework and explain why things like health, security and continued foreign aid -- even in that place where you give no credit for saving lives in africa and humanitarian things, even without that, this is money well spent. >> tell him we say hello. >> thank you for this

conversation. [applause] >> a special thank you to gallop our host, everyone in the room and thank you for tuning in. have a great day. [applause] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] ♪ this month on c-span we feature our studentcam contest winners. we ask middle and high school students to choose the provision of the u.s. constitution and illustrate why it is important to them. our second prize middle school angel, mariaulia