By Kent Allen
TACOMA, WASH.--Although she's a generation past her own student days, Patty Stonesifer sits in a high school classroom, diligently taking notes. On a mild afternoon in late October, she's interviewing four students at the Tacoma School of the Arts, a new public high school that uses urban cultural venues for instruction in the performing and visual arts.

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"How did you decide to come here? What's the toughest class? What's the one thing you don't get here that you would in a regular school?" asks Stonesifer. She queries the teenagers with the eagerness of a prospective parent undecided about enrollment and the directness of a headhunter looking for budding talent. Stonesifer has played both those roles, yet she is neither on this outing.

From her office in Seattle, Stonesifer has come to this nearby corner of Puget Sound in her capacity as cochair of the Bill and Melinda Gates Foundation, whose namesakes are the richest family in the world. With a $24 billion endowment from the first family of Microsoft, it is the largest grant-making organization in the philanthropic world. The foundation helped put the Tacoma school in operation two years ago with a $450,000 grant. Stonesifer, a former Microsoft executive who is close to the Gateses, is examining the return on investment.

For many grant makers, to say nothing of grantees, nearly half a million dollars would be an enormous bundle. But for the organization Stonesifer runs, which doles out more than $1 billion a year, the number could represent a rounding error. The Gates Foundation grants tens and often hundreds of millions of dollars to specific programs--child vaccination in Africa, creation of small high schools and big college scholarships throughout the United States, better nutrition worldwide.

In many respects, the Gates Foundation is rewriting the book on large grant making. And Stonesifer, who makes regular site visits around the world, authors the outlines for this work in progress. "We really still have that opportunity on that blank sheet of paper," she says. The 47-year-old former businesswoman still speaks in for-profit terminology, despite her now very different mission. "We feel more like a start-up," says Stonesifer. "But we have the opportunity to do it at a certain scale and hope that those models will stand."

With this pushing-the-frontier stance, the Gateses aim to reverse what they view as gross inequities in the world. Many of their health programs in Africa, for example, target countries with per capita income of a few thousand dollars a year. Helene Gayle, director of the foundation's global HIV, tuberculosis, and reproductive-health program, says that whereas 90 percent of past research dollars have gone to help 10 percent of people, the Gateses seek more balance. They "are both really optimistic about the 21st century, but they're dissatisfied," says Stonesifer. Her job, she says, is to spot people who can help address the issues the family feels its largess might benefit.

Hands-on. Stonesifer's low-key manner matches the foundation's modern but modest headquarters, a three-story, unadorned structure adjacent to a scruffy, light-industrial area. "I spend a significant amount of time just learning the issues," says Stonesifer, who draws lessons from each undertaking. This fall, she is in the thick of a financial review in preparation for funding programs in the next couple of years. She spends about a week and a half every month on the road, observing programs and talking to grantees.

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