Leadership & Management

Gates Foundation CEO: Good Intentions Aren’t Enough

Sue Desmond-Hellmann shares what she’s learned as the leader of the world’s largest charitable organization.

January 23, 2015

| by Bill Snyder



“One of the most efficient ways for people to lead is to be really clear about what you’re asking of people,” says Sue Desmond-Hellmann, CEO of the Gates Foundation | Natalie White

Bill Gates probably didn’t know it, but he was auditioning for the role of boss when he sat down with then UCSF Chancellor Sue Desmond-Hellmann last year. She was meeting with the tech tycoon turned philanthropist to discuss a job leading the Bill and Melinda Gates Foundation, which Gates founded with his wife.


Desmond-Hellmann knew that Gates had a reputation for being demanding, even harsh. Bringing up criticism of his organization might give her insight into how the Microsoft co-founder behaves when he is angry.

“So what do you think about all the criticism of the polio effort?’” Desmond-Hellmann asked Gates. “I wanted to test what it would be like if he was fired up,” she told a gathering of Stanford Graduate School of Business students.

Gates passed the test, and so did Desmond-Hellmann, who is now CEO of the world’s largest charitable foundation, with an endowment of $43 billion. As a leader in academia and a former executive in the pharmaceutical industry, the physician and research scientist (she specialized in the treatment of cancer) managed across a variety of organizations and navigated the tricky dance between a for-profit corporation and a philanthropic group that is seeking its aid.

Desmond-Hellmann brought her lessons in leadership to at a View From the Top talk on Jan. 9:


Be yourself.

Do not adjust your personality when you become a CEO. “Great leaders show up as themselves every day,” she says.

Good intentions aren’t enough.

Solid metrics will help a nonprofit achieve real results. “If you’re in a not-for-profit world, you have to do better than good intentions, because good intentions don’t change the world by themselves,” she says.

Metrics are key.

There’s a set of expectations that come regularly when you’re running a publicly traded company, says Desmond-Hellmann. Every quarter, you have to tell the entire world how the company is performing, using metrics that are widely understood. But when you’re working at a foundation or doing research, she says, “it can be easy to continue to push the finish line forward and to put off accountability.” It’s crucial to seek out metrics, which make an organization accountable.

“Poverty is a measurable outcome; how much money does a family have? If you start to focus on poverty, you have to look long-term, but there are some metrics that can be associated with that,” Desmond-Hellmann says.

Failure is part of being an innovator.

“It’s a key part of leadership to have an environment that accepts failure and welcomes failure and encourages people to take risk,” she says. “And so the most important part of leading an innovative environment for me is enabling people to seek the truth and tell you the truth.”

Be clear about your objectives.


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“I think one of the most efficient ways for people to lead is to be really clear about what you’re asking of people and what the outcomes are,”says Desmond-Hellmann. When building a public-private partnership, for example, educators need to understand whether they are seeking charity or asking to be part of a business plan. “The consequences of misunderstanding the difference between a deal and charity are high,” she says.

Manage yourself.

“Nobody is going to understand as well as you do how much sleep you need, how much fun you need, how much exercise you need, what you should eat, who you should surround yourself with. So, manage yourself so that you can be happy,” says Desmond-Hellmann.

Reframe your view of being nice.

Desmond-Hellmann says she has learned not to be embarrassed about being demanding in pursuit of the organization’s goals, or worrying that people might think she isn’t nice. Underestimating people is not nice: A leader should be confident enough to say to an employee, “I’ll bet you’re capable of more. And, yeah, I’m going to ask you hard things. But you’re up to it,” she says.

Be fierce.

“Many overachievers feel like, ‘Oh my God, I need more work-life balance,’ or ‘I need to be easier on myself,’ or ‘I need to get more sleep.’ I honestly think you don’t get great things without trying hard. There’s something really special about being fierce when you’re doing something important or you want to create something special,” says Desmond-Hellmann.

Embrace diversity.

Bill and Melinda Gates have different views from each other and different personalities — their disagreements and differences strengthen the foundation’s leadership. “Melinda’s sense of social justice, her incredible caring for women and girls — she’s like the world’s best, most enthusiastic mom and brings all that to the job.” Bill brings his “impatience, doggedness, brilliance, and everything that Bill is, and everything he’s brought to the world he’s bringing to the work at the foundation.”

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