It takes more than money to rid the world of a scourge such as polio - though having buckets of cash certainly helps. Also needed are ambitious thinking, organisational knowhow and the ability to bring new ideas to bear on old problems. These are also the kind of things that go into creating a successful technology company. This time around, though, Bill Gates the CEO has had to take a back seat to a less familiar persona: Bill Gates the diplomat.要让世界根治小儿麻痹症这样的灾祸，光有金钱是过于的，虽然实力雄厚的资金必定是有益的。我们还必须深远影响的思维、的组织技巧、以及用新理念来对付杨家问题的能力。这些也才是是用来创立一家顺利高科技企业的要素。
但这一次，首席执行官比尔盖茨被迫让坐落于一个世人不太熟悉的人物：外交家的比尔盖茨。When the Gates Foundation made polio eradication a priority five years ago, the global anti-polio effort was running into the sand. More than 10 years of progress had given way, at around the turn of the millennium, to a stalemate as vaccination efforts in the countries still harbouring the disease failed to reach the coverage levels needed to push it into extinction. The organisations behind the existing drive - such as Rotary International, the business group that had long led the effort - “had sort of naively assumed it was on track, but it wasnt”, Gates says. “The idea that business as usual was going to get us there - it had to be broken out of that, because it wasnt going to succeed. It probably would have been better to just give up than do business as usual. But that would have been horrific.”当盖茨基金会在5年前要求优先希望根治小儿麻痹症时，全球范围抗击这种疾病的希望于是以举步维艰。
在世纪之交前后，当时早已进展10多年的项目在现实面前十分无力，那些仍不存在小儿麻痹症病例的国家里，疫苗接种的覆盖面积仍未超过能根治疾病的水平。这些致力于该运动的的组织，比如长年领导这一希望的商业团体“国际扶轮社”(Rotary International)“或许有点天真地指出一切都在正轨上，但事实却并非如此。”盖茨说道，“有人指出一切如常就不会达到目标，但这会顺利，我们必需跑出这种点子。索性退出或许比一切如常更佳，但那将是十分可怕的。
”Gates seems to relish nothing more than challenging business as usual, often by applying a dose of more ambitious thinking. It was the same impetus that led him to rethink familiar approaches to philanthropy, throwing his money into the urgent pursuit of solutions to big problems rather than attempting a drip-feed of donations that would amount to little more than a Band-Aid. While the foundations started by the likes of Howard Hughes and pharmaceuticals boss Sir Henry Wellcome are still among the handful of the worlds richest decades after their founders deaths, the Gates Foundation has been programmed to dole out all its cash and wind itself up 20 years after their deaths.盖茨或许最喜欢挑战“一切如常”，他常常为此进行更加深远影响的思维。某种程度的动力促成他反省人们熟知的慈善作法，并最后要求把自己的大量财富花上在为根本性问题找寻解决方案这一严峻任务上，而不是展开小打小闹的捐献、到头来无法彻底解决问题。尽管霍华德休斯(Howard Hughes)和制药业大佬亨利惠康爵士(Sir Henry Wellcome)创办的基金会，在其创始人去世几十年后仍位列世界上少数财力十分实力雄厚的基金会之佩。盖茨基金会则计划在盖茨夫妇去世后的20年内捐献所有资金，然后转入清盘程序。
The instinct to shake up the complacent and challenge the intellectually lazy doesnt always win Gates friends. Putting his personal money and reputation on the line to eradicate a disease has also risked accusations of vanity - a case of the “ego philanthropy” that can distort goals when the super-rich get involved. Wiping out a disease has only happened once before, when the World Heath Organisation declared in 1980 that smallpox had been eliminated. Helping to finance and organise a second eradication would cap the Gates Foundations emergence as the most significant private charity in the world of global health. It would also set the stage for the next items on the list of diseases it hopes eventually to wipe out, starting with malaria.动摇可笑、挑战思维惰性的本能，并不总能让盖茨夺得朋友。为根治一种疾病而押上自己财富和声誉的作法，还有有可能被人谴责为“贪婪”——“自我慈善事业”所指的就是这种情况。当牵涉到超级富豪时，这种慈善可能会变形目标。
根治一种疾病的案例以往只再次发生过一次——世界卫生组织(WHO)在1980年宣告天花已被根治。若能协助资助和的组织根治第二种疾病，盖茨基金会将一跃沦为全球身体健康领域最重要的私人慈善机构。此举还将为该基金会奠下基础，有利于将目标改向其期望最后根治的其他疾病，派的就是疟疾。
Gates brushes off questions about the merits of the eradication effort and whether other initiatives might be a better investment in terms of the immediate number of lives saved. “Eradications are special,” he says. “Zero is a magic number. You either do what it takes to get to zero and youre glad you did it; or you get close, give up and it goes back to where it was before, in which case you wasted all that credibility, activity, money that could have been applied to other things.”有人批评根治疾病希望的价值，指出若按被挽回之生命的必要数量来取决于，其他乐善好施不会会是更佳的投资。面临这些批评，盖茨回应狂妄。
“‘根治’是一件很尤其的事情。”他说道，“零是一个神秘的数字。你要么尽一切希望来超过零，然后对自己构建了目标深感伤心；要么在相似目标后退出希望，然后发病率声浪至原先水平——在这种情况下，你白白浪费了大量信誉、精力和资金，而这些你原本可以投放到其他事业上。
”Since he threw his organisation behind the effort, polio has been eradicated in India. But it remains rooted in Afghanistan, Nigeria and Pakistan, spilling over sporadically into their neighbours. That these three countries remain among the worlds most difficult to operate in - in Pakistan, the Taliban has taken to bombing vaccination teams, accusing them of being in cahoots with the CIA - provides a clue about why, nearly 30years after the eradication campaign began, polio persists. Eradication has little to do with making advances in science and technology - though work on new vaccines targeted more directly at the strains of the disease that remain has helped in the fight.有赖盖茨基金会的反对，小儿麻痹症在印度已获得根治。但这种疾病在阿富汗、尼日利亚和巴基斯坦依然风行，有时候还蔓延到邻国。这三个国家仍是世界上最无以积极开展慈善工作的，在巴基斯坦，塔利班曾对疫苗接种小组实行炸弹攻击，并谴责他们与美国中央情报局(CIA)同流合污。
这一事实实则说明了为什么在“根治”希望启动近30年后，小儿麻痹症依然不存在。能否根治疾病与科技否获得变革关系不大，尽管在这一希望中，新的疫苗（这些疫苗更加必要地射击现存疾病类型）的研制工作起着了协助起到。Take one of the biggest challenges to managing immunisation campaigns against polio and other diseases in the developing world: getting vaccines to where theyre required while keeping their temperature in a narrow 2C-8C range to prevent them spoiling. Running the so-called “cold chain” needed for this to happen - from big refrigerators in regional distribution centres to the cases vaccinators carry into the field - requires painstaking logistical organisation. Often, kerosene or other fuels used in refrigeration are in short supply or antiquated equipment fails due to lack of maintenance. According to Gates, problems like these are too low-tech to attract the worlds best brains. “Unfortunately, its a very mundane, practical thing,” he says. “Its not sexy from a scientific point of view.”在发展中国家积极开展针对小儿麻痹症和其他疾病的免疫系统活动，仅次于的挑战之一是把疫苗载运到必须的地方，并在这一过程中保证它们的温度维持在2至8摄氏度的狭小温度范围内，防止它们变质。
要做这一点，就必须所谓的“冷链”：从区域配送中心的大冰箱，到疫苗人员手中的疫苗箱。运营“冷链”必须展开周密的后勤的组织。常常再次发生的情况是，加热器所用的煤油或其他燃料供应紧缺，或者设备陈旧，年久失修经常出现故障。盖茨称之为，这样的问题技术含量太低，无法更有世界上最杰出的大脑。
“失望的是，这是一件很憧憬、实际的事，”他说道，“从科学的视角看，它过于‘性感’。”A businessmans understanding of incentives helps. The number of fridges needed is not large enough to provide a profitable market for manufacturers so the foundation has had to make financial commitments in advance. The business model of the vaccine makers gives them little reason to lower their manufacturing costs to make their products more affordable, he adds. Their high costs are more than covered by prices they can charge in the developed world and any mistakes they might make as a result of tampering with their carefully regulated production processes would jeopardise that existing business. “Thats not science - thats, how the hell do you make 50 cent vaccines?”此时商人盖茨对激励机制的解读是十分简单的。由于所需的冰箱数量过于、无法为制造商获取一个有利可图的市场，盖茨基金会被迫预先做出财务允诺。
他补足说道，疫苗制造商的商业模式使得它们没理由降低生产成本、让自己的产品在价格上更加适合。在发达国家需要班车的价格，不足以覆盖面积它们的高成本。
如果它们因转变自己精心调校好的生产工艺而引致任何差错，那就有可能严重威胁现有业务。“这与科学牵涉到——这个问题是，你如何才能生产50美分的疫苗？”Management methods that would be immediately familiar to anyone involved in the fast-moving technology world are also being brought to bear. These include employing the rapid cycle of trial and error that new tech companies engage in before pouring money into a formula that works - a process known as “scaling”, which takes place as they race to capitalise on a new market before rivals emerge.瞬息万变的科技行业的参与者所熟知的管理方法也被引进。还包括使用较慢的试误周期——新的科技公司往往不会再行展开试误，然后再行砸下重金将其中一种管用的设计方案投产，这个过程称作“规模化”，目的是让它们抢走在竞争对手经常出现之前独霸一个新的市场。Apoorva Mallya, a senior program officer who works on country implementation, puts the success in stamping out the disease in India partly down to pouring money into local initiatives that had the potential to be effective across the country, but which were being conducted on too small a scale to make a difference. These included assigning community mobilisers to individual districts and neighbourhoods before vaccination drives began in order to organise meetings of women and overcome distrust or resistance. “We went in and funded them for a massive expansion across India,” he says.在国家层面负责管理实行的高级项目官员艾普瓦马尔雅(Apoorva Mallya)指出，他们之所以需要在印度顺利根治这种疾病，一定程度上是因为他们将大笔资金投向了地方性的项目；这类项目本已不具备在全国有效地实行的潜力，但因规模过小影响力严重不足，还包括在疫苗接种活动开始之前向各区和街道指派社区动员者，由其的组织妇女召开，解决不信任或杯葛情绪。
他说道：“我们插手其中并获取资金，让他们在印度各地大规模推展。”Another method familiar from the tech world involves more effective data collection and analysis. Vaccination drives fail if too many children fall through the net. To get a better understanding of effectiveness, the foundation has paid for teams of researchers to use statistical sampling to see if adequate coverage levels have been reached.从高科技行业糅合的另一种方法涵括了更加有效地的数据搜集和分析。如果有过于多儿童“漏网”，疫苗接种希望就不会告终。
为了更佳地掌控行动的效果，盖茨基金会资助了一些调研小组，用统计资料取样来辨别否已超过充足低的接种率水平。Measurement is also being brought to bear to build a more detailed understanding of how costs are incurred in vaccination drives. Without that data, its hard to know where to focus attention to make global health programmes more effective, says Orin Levine, who runs the foundations vaccination efforts. “We dont necessarily differentiate where the costs are in the system yet, so it makes it harder to say an innovation in [a particular area] will be something we really want,” he explains.为了更加精细理解疫苗接种项目的各项成本，盖茨基金会还引进了一些测算手段。
负责管理该基金会疫苗接种工作的奥林莱文(Orin Levine)回应，如果没这些数据，就很难告诉应该在哪里集中于注意力，才能使全球身体健康计划显得更为有效地。他说明说道：“目前我们未把整个系统中的各项成本都粗列出来，也就是说很难说某一领域的某项创意是我们确实想的东西。”This kind of rigour would be familiar inside an engineering-centric company such as Microsoft, where rationality reigns. But in the more chaotic world of global aid, with its loose alliance of government agencies, NGOs and charities - many of them operating with only partial information - it does not pay to assume such disciplines. Learning to work in that world is one of the greatest adjustments.在微软公司这种以工程为中心、理性平等主义的企业中，人们对这种缜密会陌生。
但在由政府机构、非政府的组织和慈善机构构成牢固联盟的全球援助领域，局面则更加恐慌，很多机构是在仅有掌控部分信息的情况下积极开展工作。在这样的环境中，要秉持这样的纪律不免吃力不讨好。学会在该领域工作是盖茨做出的仅次于调整之一。
“The fact that people dont understand numbers and systems thinking and science and logic, thats OK,” Gates says - though his famous impatience might belie such a claim. “I only need a half of the people who contribute to really think in a way where I can say, hey, come on, theres a theory of change here, do you get it, do you get if that piece doesnt happen, it completely messes up that piece?”“人们不解读数字和系统思维、不解读科学和逻辑，这没什么，”盖茨说道——尽管他那出了名的发脾气令其我不肯毕竟坚信他的这一众说纷纭。“我只必须一半参与者确实以合理方式思维，我可以说道，嗨，这是变革理论，你要明白，如果不（按照变革的拒绝）去这么做到，就不会完全搞砸。
”Like many self-made business people, Gates is wary about the ability of governments to deal with some of societys most pressing problems. Personal experience might have something to do with it. More than a decade ago, his fight with the US Department of Justice over whether Microsoft had acted illegally to defend its PC software monopoly ended in defeat, though a settlement with the George W Bush White House saved the company from the forced break-up that a judge had ordered.与许多白手起家的商人一样，盖茨也担忧政府应付某些最严峻社会问题的能力。他的这种担忧有可能在一定程度上源于他的亲身经历。10多年前，他与美国司法部(US Department of Justice)环绕微软公司否曾采行非法行动确保其PC软件独占地位进行过对决，并最后沦为战败的一方——尽管与小布什(George W Bush)政府达成协议的妥协挽回了微软公司，幸免于难不用按照此前法官命令的那样强迫拆分。Gates describes himself as a natural optimist. But he admits that the fight with the US government seriously challenged his belief that the best outcome would always prevail. With a typically generalising sweep across history, he declares that governments have “worked pretty well on balance in playing their role to improve the human condition” and that in the US since 1776, “the governments played an absolutely central role and something wonderful has happened”. But that doesnt settle his unease.盖茨称之为自己是一个天生的乐观主义者。
但他否认，与美国政府之间的那场斗争相当严重挑战了他的信念，他原本仍然坚信最后落败的总是最差的结局。他以一种典型的、概括总结历史的语气声称，政府“总的来说在提高人类生存条件方面很好地充分发挥了自己的起到”，在美国，自1776年以来，“政府充分发挥了意味著核心的起到，推展构建了一些伟业”。但是，这并没减轻他的忧虑。
“The closer you get to it and see how the sausage is made, the more you go, oh my God! These guys dont even actually know the budget. It makes you think: can complex, technocratically deep things - like running a healthcare system properly in the US in terms of impact and cost - can that get done? It hangs in the balance.”“你就越相似第一线、看见腊肠是如何制作出来的，就就越有可能说道，天哪！这些家伙只不过对支出一头雾水。你不由得不会想要：如果让他们去做到些简单的、在专业管理方面有点深度的事情，比如在美国运营一个有影响又具备成本管理的医疗系统，他们需要做到吗？这有点覆。”It isnt just governments that may be unequal to the task. On this analysis, the democratic process in most countries is also straining to cope with the problems thrown up by the modern world, placing responsibilities on voters that they can hardly be expected to fulfil. “The idea that all these people are going to vote and have an opinion about subjects that are increasingly complex - where what seems, you might think... the easy answer [is] not the real answer. Its a very interesting problem. Do democracies faced with these current problems do these things well?”问题不只是政府有可能无法胜任涉及任务。
按照这种分析，多数国家的民主进程也在艰苦应付现代世界带给的种种问题，让选民分担他们似乎很难遵守的责任。“有人主张，让所有人都去投票、就某些领域中日益简单的课题构成一个意见——而在这些领域中，你或许不会指出，那些奇特……更容易的答案并不是确实的答案。
这是一个很有意思的问题。面临当前这些问题的民主国家，在此类事情上做到得究竟好不好”Compared with fixing the US healthcare system, the issues of global health and development taken on by Gates foundation are, by his own estimate, relatively straightforward. But the work has required him to develop new skills: a willingness to engage with politicians and to develop reserves of diplomacy and persuasiveness. With more than 1,000 staff members and the ambition to shape the broad strategies directed at solving the problems it takes on, the foundation does much more than simply hand over money. It relies on partnerships with a wide range of government agencies and other bodies to have any effect - and that has forced Gates, the uncompromising and impatient tech leader, to apply the human touch.按照他自己的估算，与修缮美国医疗体系比起，盖茨基金会应付的全球身体健康和发展问题要更为直截了当。
但这项工作拒绝他习得新的技能：培育与政界人士认识的意愿，修练外交手腕和说服力的内功。盖茨基金会所做到的近不只是派发资金，该基金会享有1000多名工作人员，并立志要针对问题塑造成整体上的解决问题战略。要想要产生实际影响，它必需与各类政府机构和其他的组织创建合作关系，这被迫盖茨这个不让步和发脾气的科技行业领袖学会跟人做事。
Workers at the foundation say that he has been closely involved even at a regional and district level in winning the needed political backing. Gates, for instance, says he personally “bonded with” Nitish Kumar, the highly rated chief minister of the Indian state of Bihar, over the latters strong backing for vaccination efforts.基金会的工作人员称之为，盖茨仍然紧密参予谋求适当政治反对的工作，甚至在区域和地区层面上也是如此。例如，盖茨说道，他与印度比哈尔邦(Bihar)倍受赞誉的首席部长尼蒂什库马尔(Nitish Kumar)结为了很好的私交，以保证后者需要鼎力支持疫苗接种。Sometimes in the field of global development, however, it is enough simply to be Bill Gates: the fame and wealth work their own magic. “If... I need to go to the Indian parliament and say, Lets get serious about vaccines,” then yes - since Im giving my own money [on a] large scale and spending my life on it and Im a technocrat - yes, that can be quite valuable.”然而，在全球发展这个领域，有时意味着做到返比尔盖茨就充足了：他的名气和财富不会自动产生魔力。
“如果……我必须去印度议会说道，‘让我们认真对待疫苗接种工作’，那么到底——由于我拿走自己的大量财富、全身心地投放这项事业，而且我是个技术官僚——这一切有可能非常有价值。”If this brand of international development diplomacy has required new skills, however, some things havent changed. Talk to almost anyone who has worked with Gates and they have a story about his intensity. On trips to the developing world his tirelessness wears out those around him. Inside the foundation, he shows the kind of endurance that once inspired and exhausted Microsoft product managers. “He wants to do the work with us at the most granular level. He will sit in four-hour meetings with us going over slide page after slide page,” says Raja Rao, who heads the foundations work on perfecting the cold chain. “Ive seen him sit in a room for 11hours non-stop just talking about technology, eating snacks and drinking Diet Coke.”不过，如果说展开此类注目国际发展的外交活动必须习得技能，那么有些东西是仍然没转变的。
曾与盖茨共事的人完全都会谈及他对工作的高度投放。在前往发展中国家的旅途中，他马不停蹄让周围的人筋疲力尽。
在盖茨基金会内，他展现了曾多次激励（并且累坏）微软公司产品经理的那种耐力。“他要和我们一起做到那些最荒谬的事。他不会参与我们的4小时会议，逐页稿件幻灯片。
”在该基金会负责管理冷链完备工作的拉贾拉奥(Raja Rao)回应，“我见过他躺在一个房间里，倒数11个小时不时地谈论技术、吃零食、喝健怡饼干(Diet Coke)。”Many of the works on the bookshelves in Gates office overlooking Lake Washington are scientific tomes on the diseases that he is combatting - of which, with characteristic diligence, he now has a deep personal understanding, according to others at the foundation. A voracious reader - he has always taken periodic breaks from his regular routine to read about and ponder the biggest problems he has taken on- his conversation is littered with references to authors. Given the smallest excuse, he plunges into a description of the different types of polio and vaccines - and then into the genetic tests that show how the disease once persisted and spread in areas like Uttar Pradesh even when full outbreaks were rare.在盖茨眺望华盛顿湖的办公室里，书架上摆放着很多关于盖茨所抗击疾病的科学著作。
据盖茨基金会的人讲解，凭借着标志性的刻苦，如今盖茨对这些疾病有了深刻印象的个人解读。盖茨是一个博览群书的人，他有一个维持了很久的习惯，那就是间隔一段时间继续道别日常事务，专心读者和思维自己自由选择应付的根本性问题。
他在谈话中也屡屡提到有所不同作者的观点。哪怕获得大于的由头，他也不会滔滔不绝地讲解有所不同类型的小儿麻痹症和疫苗，然后又说道，基因测试表明，这种疾病如何一度在印度北方邦(Uttar Pradesh)等地持续经常出现和传播，尽管很少有疫情全面愈演愈烈的情况。This is the Gates who once ruled Microsoft with a command of detail and intellectual intensity that led to the kind of culture that was capable of dominating the tech world - even as it tipped over into behaviour that brought a regulatory backlash. “I was a kind of hyper-intense person in my twenties and very impatient,” he says. “I dont think Ive given up either of [those] things entirely. Hopefully its more measured, in a way.”当年的盖茨正是凭借这样高强度的思维和对细节的掌控来领导微软公司的，它促成了需要主导高科技行业的那种文化——也促成了最后招来监管声浪的越线不道德。
“我在20多岁时是那种绷得十分凸的人，十分没冷静。”他说道，“我毫无疑问自己在这两方面已几乎转变。
只是期望自己显得更加有分寸了。”If the manner has mellowed, though, the uncompromising attitude is still very much in evidence. It is at once one of the strongest assets and one of the biggest hindrances in his plan to save some of the worlds poorest from the fate to which a sometimes oblivious world has left them. Knowing how to pursue an unflinching personal logic without alienating people remains a work in progress for him.不过，如果说盖茨的粗鲁已显得更加有分寸，那么他的不让步态度可以说道仍十分显著。
盖茨的计划目的解救世界上一些最贫困的人群，使他们挣脱这个有时对痛苦视而不见的世界带来他们的命运。就该计划而言，盖茨的不让步态度既是最强劲的资产之一，也是仅次于的障碍之一。明白如何在不得罪人的情况下执着忠诚的个人逻辑，对他而言仍是一种必须更进一步修练的内功。“When we had a meeting a couple of years ago, when people werent thinking through the polio thing very well, I was pretty critical,” he says. His message to the assembled workers: “Hey, this is not good thinking, this is not good, this is not going to get us there.“”盖茨说道：“在两三年前的一个会上，当有关人员没能周密考虑到根治小儿麻痹症的项目时，我的态度非常不客气。
”他向参会工作人员表达的信息是：“这种思路可敢，它过于好，无法让我们达到目标。”The new Gates, though, was not prepared to leave it at that. After the meeting was over, he did what husbands the world over are liable to do at such times: “I said to Melinda, was I too tough on that, who should I send mail to, was that motivational, de-motivational? Its all a matter of degree.”不过，“新的”的盖茨并没想不去想要这件事了。
会后，他做到了世界各地的有家男人在这种时候都可能会做到的事：“我对梅琳达说道，我在这事上过于严苛了吗？我应当给谁发封邮件？我的话是有鼓舞起到还是让人鼓起？这些全都是一个‘度’的问题。
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