World's richest man's imprint on Africa

In 1999, the Gateses donated $750 million to found the Global Alliance for Vaccines and Immunization (GAVI), an organization aimed at improving access to immunization. Since GAVI's founding, an additional 8 million children have received basic vaccination and 30 million have received new vaccinations that were previously unavailable.

"[Bill Gates] became interested in vaccines because, first of all, he saw that this was something his own children were getting but children in other countries were not," says Tore Godal, executive secretary of GAVI. "But also, I think he saw it as analogous to software development. Difficult to develop, but easy to use."

When Gates first started becoming involved in African health issues, there was initial skepticism of his approach.

"There was some criticism at first, that he was very American to look at short technological solutions to complex issues," says Lisa Jacobs, spokeswoman for GAVI.

But officials at GAVI say those fears were quickly put to rest. Now, because of the Gates's donations, GAVI, which brought together private donors, international organizations like UNICEF, national governments, and pharmaceutical companies, has become a model for funding large public-health projects and an inspiration for the United Nations Global Fund to Fight AIDS, Tuberculosis, and Malaria.

"There is a recognition that the traditional way of doing this wasn't working," says Dr. Godal, who says the Global Fund and other groups have now borrowed GAVI's way of requiring countries to apply for funding from a central fund. "We needed a new approach that would be innovative and risk taking."

In addition to the large new donation to fight this week, the Gateses checked on the progress of research into microbicides in Johannesburg - new AIDS-prevention methods for women to which they've donated $60 million. They also met with Botswana's President Festus Mogae about that country's program to give free antiretrovirals to people with HIV, to which the Gateses have donated $50 million.

To date, the Gates Foundation has sent half its money to improve health in the world's poorest countries. In addition to higher-profile diseases like AIDS and malaria, it also contributes to fighting lesser-known problems, such as the Guinea Worm Disease.

For Mrs. Gates, philanthropy is a responsibility of privilege. She describes her family as an ordinary one - with extraordinary wealth.

"When we're back at home, we don't sit around the dinner table among ourselves, talking about the enormous change that we're going to make across the continent," she said in Mozambique. "But we do try and share with our children some of the needs of children around the world, because we do want to instill in our children a responsibility."

The Bill and Melinda Gates Foundation has an endowment of $24 billion, consisting solely of personal donations from the Microsoft founder and his wife. Since 2000, more than $6.2 billion has been distributed worldwide.

Global health $3.22 billion

Education 1.84 billion

Special projects 489 million

Pacific Northwest 478 million

Libraries 227 million

Employee matching, gifts, and sponsorship 1.64 million

Source: Bill and Melinda Gates Foundation

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