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Clinton, Gates Join Forces
In a Global Effort to Fight AIDS
  Two Bills, One Mission
Vastly Different Personalities,

Wall St Jnl
July 11, 2006
THEIR STYLES are worlds apart, but they have at least two things in common: supersize egos and a zeal for bettering global health.
Bill Gates, chairman of Microsoft Corp. and the world's richest man, gives away billions through his family foundation to underwrite health programs from childhood vaccines in Africa to AIDS prevention in Indian truck stops. Bill Clinton is shorter on spending power, but the former president is rich with powerful friends and skilled in the art of negotiation, enabling him to broker deals for AIDS-drug discounts and persuade governments to do more for patients.
Though the two men have rubbed shoulders for years at elite gatherings around the world, it has only been in recent months that the two began joining forces. Mr. Gates has funded a small grant ($750,000) to the Clinton Foundation to explore the best ways to roll out expanded access to drugs for HIV/AIDS. Today Mr. Clinton will speak at Mr. Gates's Microsoft Government Leadership Forum in Capetown, South Africa, and tomorrow the two plan to travel with Mr. Gates's wife, Melinda, to Maseru, Lesotho, to visit sites including the Clinton Foundation HIV/AIDS Initiative Clinic.
And next month, Messrs. Gates and Clinton will make their highest-profile joint appearance yet when they share the podium at the XVI International Conference on AIDS in Toronto, addressing thousands of scientists, activists and media on how to fight the threat of HIV. Behind the budding partnership of opposites is a potential synergy between two leading figures in the new breed of philanthropists.
"I think what you're seeing is the beginning of what you might call the first super NGO...with overlapping interests and a great deal of resources," says Richard Holbrooke, Mr. Clinton's United Nations ambassador and now president and chief executive of the Global Business Coalition on HIV/AIDS in New York.
WSJ's Marilyn Chase discusses how President Bill Clinton and Bill Gates will function in their global fight against AIDS.
There is so far little formal arrangement between the two men or their foundations, and representatives from each organization declined to comment on their joint African site visits during what a Gates spokeswoman called a "learning trip." Messrs. Clinton and Gates themselves were traveling and unavailable for comment, according to aides. But the spate of joint public appearances reflects a more intense level of engagement aimed at bringing maximum attention to their cause. "They have ongoing discussions," says Helene Gayle, Mr. Gates's AIDS chief until leaving recently to become president of CARE, the Atlanta-based international humanitarian organization.
Their overlapping interests are evident in Lesotho, where since 2004 the Clinton Foundation has been helping the government with national AIDS-drug access programs at such sites as the clinic in Maseru.
Lesotho is a highly significant venue for the two to visit because of such factors as its nationwide HIV testing, and destigmatization of treatment, says Trevor Neilson, a former spokesman for both President Clinton and for the Gates Foundation and now a partner in Endeavor Group, a philanthropic-strategy firm in Washington. "It's a little country showing what can be done," he said. He adds: "It's not an exaggeration to say the two Bills are leading the world in the fight against AIDS."
Improving drug delivery to patients in poor countries is a challenge the Gates Foundation has wrestled with often. A project it ran with Merck & Co. in Botswana to provide free drugs, for example, initially struggled because the country has so few clinics and doctors, and stigma discouraged patients from lining up for treatment.
Not everyone agrees that wealthy and influential private figures should be the driving forces for improving global health. Mark Harrington, executive director of the New York-based Treatment Action Group, says the entry of Mr. Gates's fortune has transformed AIDS and biomedical research overall. But "it could give governments an excuse not to step up to the plate," he says, which is worrisome at a time when the National Institutes of Health budget is "flat and going down in real terms."
Indeed, Mr. Gates has tried to engage the G8 industrialized nations to commit to long-range global health funding, but recent infighting between some members threatens to retard programs like bond issues for vaccines. Enlisting more government cooperation is an area where Mr. Clinton excels, and this could offer him and Mr. Gates an opportunity to leverage their respective strengths.
The Bill and Melinda Gates Foundation, a $30 billion foundation that will double to $60 billion thanks to Warren Buffet's recently announced gift, has already pumped over $10 billion into grants, $6 billion for public health in the developing world. While the Clinton foundation's financial grants are more modest, Mr. Clinton's charm and diplomacy, along with his gift for uniting governments, activists and the pharmaceutical industry in common cause, are valuable assets.
A linear thinker who sees the opportunity to halt the AIDS epidemic much like a giant calculus problem, say aides, Mr. Gates likes to work independently of host governments, often refusing to channel gifts through politicians' hands, and prefers to directly fund nonprofit partnerships. Mr. Clinton -- the consummate insider -- works hand in glove with host governments, even occupying office space inside ministry offices. Having induced Chinese government officials to hug a spike-haired AIDS activist at a town-hall meeting, the former president often brags that the event launched a new era of transparency about AIDS in China.
Ira Magaziner, longtime senior adviser for policy development in the Clinton White House and now executive director of the Clinton Foundation, in an interview last year cited a key difference in the approaches of Mr. Clinton and Mr. Gates to AIDS in India.
"The Gates Foundation is doing good work but doesn't have a direct agreement with government," he says. "He is private-sector and NGO-oriented. We're providing a small amount of money but that's not our main activity. We're not going to compete with Gates or the U.S. government at handing out money. We mostly provide technical assistance."
In 2003, Mr. Gates awkwardly upstaged his own gift to India, a $200 million AIDS-prevention program, by roiling the New Delhi government by citing high AIDS projections for India made by the Central Intelligence Agency. Mr. Clinton engaged the government on AIDS without a ripple of controversy. Congratulating the newly elected government of Congress Party leader Sonia Gandhi and her prime minister, Manmohan Singh, Mr. Clinton traveled to India in July 2004 and by September had signed what Mr. Magaziner said was that country's first deal with a private U.S. foundation. Both projects are now well under way.
"Gates doesn't work as well with governments because he doesn't have the skills or political acquaintances," says Mr. Holbrooke. "Clinton doesn't have the resources. But Clinton is the most important public figure and Gates the most important financial figure." And while differences between the two are "true," says Mr. Holbrooke, they are "of low-level importance." He adds: "What's important is there's a marriage of many organizations of which Clinton's and Gates's are the most powerful."
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