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What do you do when someone gives you a gift of $30 billion? First you cry, said Patty Stonesifer, CEO of the Bill & Melinda Gates Foundation from its inception in 1997 until August 2008.

Stonesifer recently described to a Stanford audience both the overwhelming generosity and daunting challenges of Warren Buffett’s 2006 decision to entrust $30 billion to the Gates Foundation.

Challenge No. 1, she said, was to make sure the immensity of the gift did not cause other donors to step back and assume that Gates alone would “solve” problems such as malaria and inadequate public schools.

She aggressively sought partnerships with many other groups, public and private, including the William and Flora Hewlett Foundation, the Carnegie Foundation and the World Food Program.

Another challenge, Stonesifer said, was giving away the money on the swift schedule specified by Buffet. “How do you responsibly return this to society at this pace?” she asked herself and her staff. Eventually program officers developed a “Holy Cow Award,” in which staff members choose colleagues who have excelled at carrying out that challenge.

“I hope we’ve lived up to Warren’s expectations, and I’m sure we’ve made some mistakes,” she said, noting that a measure of uncertainty, boldness and experimentation is inherent in finding new ways to solve problems.

Stonesifer, the sixth of nine children who grew up in Indiana, was before the age of 40 the highest-ranking female executive at Microsoft. Often the only woman in the room, she would find herself thinking of the Sesame Street jingle, “Which of these things is not like the other?” However, she said that now is a time when people are becoming freer to be themselves. Many women have succeeded not by trying to imitate men but by doing things their own way, she said.

From its early days, a core value of the Gates Foundation has been that “all lives have equal value and everyone should have the opportunity to lead healthy and productive lives,” Stonesifer said. Seeking to address the greatest barriers to that goal, the Gates family decided to focus their resources on education in the United States and on health in the developing world.

Stonesifer’s lasting observations from her decade at the foundation are that good leadership is critical to solving problems and that despite the enormous value and transformative nature of technology, human factors play a huge role, she said.

“Often solutions can be so close at hand with a little bit of ingenuity,” she said, citing a simple $40 water pump that doubles the number of growing seasons for farmers in India. She was pleased to learn that profits from the extra growing season made it possible for the first time for some farmers to marry and was delighted to hear from them about babies on the way.

Stonesifer currently serves as senior advisor to foundation trustees Bill and Melinda Gates and Warren Buffett. In addition, she chairs the Board of Regents of the Smithsonian Institution. She spoke at a free public seminar sponsored by Stanford’s Center on Philanthropy and Civil Society.

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