A Heavy Dose of Confidence

Adam Crowley, Bill & Melinda Gates Foundation

When Sue Desmond-Hellmann took over as head of the Bill & Melinda Gates Foundation 16 months ago, the couple gave her a formidable to-do list. They want their foundation to lead the charge in wiping out diseases like polio and malaria, preventing the spread of AIDS, reducing by two-thirds the number of women who die in childbirth, slashing in half the mortality rates for kids under 5, and preparing every American child for college and the work force.

The job is huge and the timetable tight: The Gateses would like Dr. Desmond-Hellmann to make significant progress on these and other ambitious goals to change the world in 15 years.

Sounds impossible?

The foundation chief leans across a table in her small Seattle office and delivers a response worthy of a prizefighter.

“Bring it on.”

Habit of Intensity

Dr. Desmond-Hellmann’s track record suggests she has the mettle to make big things happen. Her scrappy competitiveness was evident even as a child. Her family refused to play Scrabble with her, she recalls, because she was too intense.

“I learned I probably needed to funnel my competitive nature into more productive venues if I ever wanted anyone to be in my orbit,” she says.

Instead of aiming for triple-word scores or other such pursuits, she became a doctor and dove into the world of medical research.

At the Gates Foundation, she would like to foster the same spirit of competition she exhibited in the 1990s at Genentech, where she was in charge of getting U.S. Food and Drug Administration approval for the breast-cancer drug Herceptin.

Other biotech firms were closing in on getting approval for similar drugs, and Dr. Desmond-Hellmann says she faced a constant chorus of skepticism. “You guys can’t get it done,” she heard, and “you can’t bring it through trial.”

Now, with a different set of challenges ahead of her, she pauses a moment before revealing the inevitable result of the cancer-drug battle: “Guess who won?”