Microsoft legend fights to end polio

>>> welcome back to " morning joe ." it's 22 past the hour. beautiful day in washington. here with us now from capitol hill , we have the co-chair of the bill and melinda gates foundation , bill gates , co-found co-founder of microsoft . mike barnicle and rick stengel are still with us.

>> mr. gates, great to have you here. you are of course -- we look behind you and see the capitol behind you. how do we measure the performance of the men and women who work in that building behind you and how important is it to start applying best practices to not only our governing body there but also to people who decide what the rules of the game are for you?

>> well, i think those people are working hard but right now the uncertainty about the budget means that the government is particularly inefficient. that means when you want to make a plan that's going to take multiple years, you don't know if you have the money, if you want to try to hire someone from the private sector . you're going to have a hard time because of those uncertainties. so the lack of direction is making these programs less effective than they would normally be.

>> is it particularly frustrating for you and other people in the high tech industry that we can't even allow people from other countries to come to this nation and help grow our businesses here if they have certain skills that some of our people don't have?

>> that's certainly been an issue. and there is up in the senate a bipartisan agreement on how this program could be expanded significantly and allow the people who come from overseas and get educated here and get offered high paying jobs that create other jobs around them, those people could be welcomed to the country. the issue is tied to the broader immigration problem which is tougher so this high skills piece, i think, if that was by itself, you would have quick agreement but right now it won't -- it's not planned to be pushed through except as part of large immigration bill . there isn't the same bipartisan agreement at this point.

>> last time you were here you talked about using metrics to measure success.

>> the private sector is the best at coming up with measures that count and constantly making sure they are making progress and looking at anyone else who is doing a similar thing and if they're making more progress learning from them. at that lesson can apply to government programs. in foreign aid where we have very limited dollars and so much need, the idea of okay which vaccine should be gotten out to people, which country is doing a good job delivering that vaccine, how do we get those numbers and make sure that we learn from the very, very best. that has really been in the last ten years the aid is focused on that. before that it was very much this country is against the soviet union . they're our friend. we won't be that picky about how they spend the money. now it's less about the cold war and more about the humanitarian benefit and the stability that leads to far better national security environment that people are healthy, population growth is less, country is stable, you won't have unrest that causes gigantic military costs. this business-like thinking is something that our foundation is trying to pioneer and trying to partner with others and set an example. it's the only way we'll succeed with polio ratification. if we are driven to find the best approach.

>> let's talk about that. there's a goal that you have to eradicate polio by the year 2018 . how do metrics play into that?

>> well, the magic here is you have to get 90% of the kids to have these vaccine drops and so you have to hire vaccinateors and make sure map is right about where they go. it's 9 million a year for the next year to get this done. no more polio. you won't have to spend money. when i was on the hill yesterday i was asking for 150 million allocated to really get it done to go up to 200 million. so that's an extra 50 million which normally for something of such great import would be simple. it's a tiny thing. with the budget uncertainty even something as important as that will take a lot of very hard work so the u.s. in total would be the second biggest donor after our foundation. it's a plan that's very measurement orientated. this is the thing i spend most of my time on now.

>> you mentioned a word that we hear over and over and over again from people that arrive here from the world of business and it's uncertainty. we hear uncertainty, uncertainty, uncertainty. can you give us some specific examples of how this uncertainty impacts not only your global fund , but the business that you help form, microsoft . how does it impact it on a daily or weekly basis?

>> well, for microsoft government related revenues aren't gigantic enough that the budget uncertainty is a big problem for them. as you get out into things like foreign aid or companies that are, you know, say defense suppliers, the idea of what should i be doing, will this program go forward? what do i say to my people about building up capacity? it can't go on like this. even by government standards it's fairly unprecedented to have budgets that could go down by so much and even the accounting of how you're supposed to quickly cut programs, does that mean is it okay to just defer building maintenance? is it really allowed to do these furloughs? the system wasn't designed for the cuts to be done this way. so hopefully we'll get back to a more normal budget process .

>> rick?

>> bill, good morning. as you know we did a story recently about efforts to eradicate polio and your efforts which i commend you for. one of the things we discovered, which i think you know as well, is that in places like pakistan and afghanistan, there is a resurgence of polio in small pockets where people are prevented from giving the injections and where basically folks like the taliban feel like this is a western plot to infiltrate their country. is that frustrating to you?

>> well, yes. the insecurities are a real challenge. the access to kids is better this year than it was last year. actually last year pakistan polio cases were down. only place they were up was nigeria. only three countries now. you're right. the violence means that sometimes you get access and sometimes you don't. in many areas you can work with whoever the local power broker is there and you get letters of passage. so for example in afghanistan where there are several hundred thousand children we didn't have access to, now we have access to all but 30,000, which means we'll be quite successful up there. but the violence is the new element that's really concerning us. vaccinators have been killed in both nigeria and pakistan so it's impressive that health workers continue to work on this. we believe the plan can succeed. anything we can do to up the security to make it clear this is beneficial for all children to get muslim voices behind us which a lot of them are speaking up in a fantastic way, that's why it still hangs in the balance whether this disease will be eradicated.

>> really quickly. as we end here, you were, i guess, at a politico interview and you suggested that on some days even though our system works better than great britain's system, you say on some days you almost wish the president had a little bit more power in the system because that way people could vote up or down parties. do you think one of the problems that we've had over the past decade is just how divided our government is and how divided our country is?

>> absolutely. it's a concern. our system has worked so fantastically over hundreds of years. we're better than anyone else 's system including the u.k. and so i hope that the self-correction where we'll elect people more in the middle or who are more focused on getting things done, you know, that that kind of thing emerges but right now it does feel a little bit dysfunctional and not only is that a concern for the u.s., the whole world looks to us as the leader. they want us to do things well and set an example and to be able to keep being generous and have a model of excellence even in things like health care where we have had such challenges. so it's definitely got to be concerning and do you see signs that people are moving back toward a pragmatic look at solving budget issues.

>> let's hope so.

>> bill gates , thank you very much. good to see you.