‘If not now, when?’: Melinda French Gates on acting without fear as a philanthropist in the Trump era  

It has been two years since Melinda French Gates left behind the Gates Foundation, which she co-founded with her former husband, Bill Gates. With an estimated net worth of $19.2 billion, she now has full control over how her philanthropic resources are used for the first time in her career—no husband or cofounder to debate. 

“It’s very freeing,” she says. 

So what is she doing with that freedom? She’s showing other billionaires how to spend their money—starting with addressing a lack of funding for women’s health in the U.S. and around the globe. 

In mid-May, that meant sitting on a couch at a former abortion clinic in Tuscaloosa, Alabama, with an 8-month-old baby on her lap. She was listening to the story of Asia Brooks, who had a difficult first birth and suffered postpartum depression. Brooks came to this clinic, WAWC, and had a completely different—and much more positive—experience for the birth of her second child last year. 

The clinic had closed after the overturn of Roe v. Wade, and then pivoted to provide other health services to women—reopening in a stately brick building that used to house a software company, funded by French Gates’ $5 million grant. French Gates was there to see how the clinic is incorporating mental health services to help people like Brooks, whose baby was busy playing with the multibillionaire’s notebook. 

Stories like Brooks’ influenced French Gates’ decision, announced today: She will put a fresh $215 million into women’s health, both in the U.S. and around the world, for a total of $600 million committed so far. Those numbers are just the start; the commitments are in a two-to-three-year “testing phase” that will focus on access to care during reproductive years, health during midlife and menopause, and mental health. With partners like the research-focused Wellcome Leap and the Menopause Society, which trains health care providers, those priorities will be applied across her firm Pivotal’s three signature levers: philanthropy, investing, and policy advocacy. 

The point is to dramatically grow support—not only from French Gates, but also from others among the ultra-wealthy. “I’m trying to send a signal,” she explains—that women’s health, always underfunded and now politicized as donors fear angering the Trump administration, is a viable category to back. 

Across two hourlong interviews, one in Tuscaloosa and one over Zoom, French Gates talked to Fortune about why this work matters to her and to the world—and how she hopes it might influence others with power. 

The following has been condensed and edited for clarity.

Why was now the right moment to add women’s health to your portfolio of work? 

Luckily, we’re living longer. I want to make sure women can reach their full potential, because when they do, society changes. Family, their community, countries change. But you can’t step into your full potential or your full power or influence if you’re not healthy. I’m also trying to send a signal that this is a space that really has not been focused on very much. 

How did your own experience in midlife influence your desire to do more work in this space? 

I had a pretty good experience, luckily, going into midlife. I was lucky enough to have a doctor who gave me options, but he did not tell me certain things about estrogen. But thank God I have older friends, and my older friends who had gone through these problems literally said, get on this now. Don’t wait until your doctor asks.  

When did it click for you that women’s health was the most important underlying factor for women to access power? 

Maybe 10 years ago. I was traveling so much, to so many countries in Africa. You’d be out in these communities and you would just see it—that if a woman had a sick child herself or she was dealing with her own illness, she just couldn’t work, she couldn’t provide. I would realize, we’re trying to help women step into their full power, have more control of the resources, more control of their decision-making. But if they are in poor health, there’s just no way. Then you carry it back to the U.S., and of course, it’s true here too. 

Are there any specific changes, pivots,........

© Fortune