The Bill & Melinda Gates Foundation has plans to address several health issues in China, including smoking and HIV/AIDS, and to observe agricultural expertise that could be used elsewhere.

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When Bill Gates takes on the role of full-time philanthropist this summer, one of the first places he’s headed is China.

That’s where the Bill & Melinda Gates Foundation will move forward on several key health programs, including HIV/AIDS prevention and a new push to curb smoking — and try to tap China’s expertise to improve African agriculture.

Gates discussed the new China initiatives in an interview as the Microsoft chairman this week leaves day-to-day work at the company he co-founded 33 years ago and looks ahead to the global work of the Gates Foundation.

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China might seem like an unlikely destination for Gates and the foundation, considering the wealth that China’s economic boom has generated in recent years.

While the country has impoverished regions with disease epidemics, it also has expertise that could help poorer countries improve areas such as agricultural production, said Gates.

“China is kind of interesting, because … it’s a recipient [of assistance], but in a lot of ways it’s a participant in the things that need to get done,” Gates said. “They have capabilities that, now that they’ve improved their economy a lot, they can be a factor to help poorer countries.”

It’s also a nation of smokers. The Gates Foundation is launching a new program to help the country cut tobacco use.

China has nearly 30 percent of the world’s smokers, according to the World Health Organization. Almost 60 percent of men in China smoke, and more than a million people a year die from smoking-linked illnesses.

Beijing has pledged a “smoke-free Olympics,” banning smoking from most indoor public spaces, workplaces and spectator areas of open-air stadiums during the summer games in August. But sharing cigarettes is entrenched in the culture.

“It will be interesting to see on tobacco how much they cooperate on that,” Gates said. “The U.S. was at a much, much higher level of wealth before it did anything about tobacco, so China has a chance to act well before the equivalent time that the U.S. did.”

Gates can observe the results himself. He said he plans to attend the Olympics.

The Gates Foundation is also making grants for hepatitis B vaccination in China, where the disease affects about 10 percent of the population.

And in agriculture, the foundation is developing programs to take expertise from China to Africa to help raise crop yields.

The world’s two leading centers for rice research are in the Philippines and China.

The Gates Foundation is working with Asian rice researchers to focus on the needs of Africa for more varieties of rice and traits like drought resistance.

“In some cases they’ve just cooperated with us without us funding any activity,” Gates said. “In some cases, we fund them to pay particular attention to the problems in the case of that crop out of Africa.”

To begin tackling the HIV/AIDS problem in China, the Gates Foundation opened an office in Beijing last year and hired Ray Yip, a former China director of the U.S. Centers for Disease Control, to head the program. It has committed an initial $50 million for the effort.

China’s government is wary of foreign nonprofit organizations working on sensitive issues. Many nongovernmental organizations are mistrusted, and the country’s top AIDS activists are routinely put under house arrest.

Gates said the foundation worked closely with the China’s Health Ministry on its programs.

“On some, like the AIDS thing, they were very welcoming, and it’s good collaboration,” he said. “It will vary by topic how much you get government cooperation on those things.”

Peter Piot, executive director of the UNAIDS, a joint United Nations program, said the Gates Foundation is making the right choice to intervene early.

“One of the lessons of the AIDS epidemic has been anything can happen,” he said. “With the incredible transformation of China as a country, as a society — changes in sexual behavior, rampant prostitution in many places. … We have epidemics in men who have sex with men in about every Chinese city we’ve looked at.”

In Africa, many of the countries where the epidemic is worse by proportion are small nations. Botswana, with one of the highest HIV rates in the world, has a population of only 1.6 million people. That’s not the case in China.

“Just imagine if we waited until 1 percent of China is infected with HIV,” Gates said. “That’s 1 percent of 1.3 billion people — that’s 13 million.”

“I think it’s money well spent,” he said. “It’s very well targeted to where the epidemic is today.”

Seattle Times reporter Sandi Doughton contributed to this report.

Kristi Heim: 206-464-2718 or

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