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Bill Gates met Melinda French in the 1980s, when he was Microsoft’s chief executive officer and she was a young associate product manager there. They married in 1994.

Now, the Medina couple are the guiding force behind one of the world’s most influential philanthropies. The Seattle foundation that bears their names granted approximately $3.4 billion last year to projects in global development, health and American education. For their public-health contributions, Bill Gates, 57, and Melinda Gates, 49, received this year’s Lasker-Bloomberg Public Service Award from the Albert and Mary Lasker Foundation.

We spoke for 55 minutes before the award ceremony last month; an edited and condensed version of the conversation follows.

Q: Melinda, you’ve become a leading advocate for family planning. What caused you to make it central to your foundation’s work?

MELINDA GATES: Well, you know, as I was traveling (in Africa) for the foundation, I would go out to speak with women about vaccines. They’d walk great distances to take their children to these very small clinics to receive vaccines. And if you’d talk to the women, they’d be pretty outraged about the fact that they didn’t have access to contraceptives. They kept saying, “I used to get a contraceptive shot; I walk to the clinic, and it’s not there now.”

And I kept hearing this over and over. (The clinics were stocking contraceptives) because of AIDS. But condoms were stocked in! Women in the developing world will tell you they cannot use condoms. They can’t negotiate a condom even in their marriage because they’re either suggesting their husband has AIDS or that they do. I thought something should be done.

Q: Do you get criticized for your support of family planning?

BILL GATES: Well, certainly contraceptives get you into — at least on the borderline of — a very controversial set of issues. But that’s fine.

MELINDA GATES: It’s not controversial in many, many other places in the world. And just because it’s controversial doesn’t mean you shouldn’t do the right thing for women. If women are telling you that, “I don’t want to have seven children, I can only feed two or three, but I don’t have a way to plan for those children,” we should do the right thing, regardless if it’s controversial.

Q: When you were considering marriage, Melinda, was the thought of marrying a man so powerful, so wealthy, intimidating?

MELINDA GATES: Well, I grew up in a family where my parents really taught us that everybody’s the same. It doesn’t matter what job you have, where you stand in the world. So I didn’t grow up with this sense of, some people are “up here” and other people are “over here.”

And — you know, I met Bill when we were both still young. I was 23 and he was 32, and he was still building the company. I saw what that took. So while the media would talk about him in one way, that wasn’t the person I knew. … So we grew during those times together.

Q: Did you two discuss what your marriage might be, that it could be a partnership to create change?

BILL GATES: Well, we knew that there were a lot of things we were embarking on together: helping each other in our work and aspirations, having a family. And we knew that there’d likely be substantial wealth from the success of Microsoft and that we’d get to figure out how to give back. We talked about that early.

MELINDA GATES: I quit Microsoft when our first daughter was born, in 1996. And so I was getting a bit more time to travel and to see things on the ground.

I would come home and talk to him about hearing from these women in the villages and men in India. Bill was very interested. He’d go and pull reports to see whether what I was saying matched. And so we were learning together, and there was already this energy around, like, “What would be possible for a foundation? What difference does a vaccine make?” And so we started taking meetings with scientists around vaccines and that really got us going.

Q: There haven’t been many marriages like yours. Did you have any models?

BILL GATES: I don’t think so. (Smiles) There were the Curies, Pierre and Marie Curie —

MELINDA GATES: Don’t think you’re going to move a lab into the foundation, the radioactive one.

Q: Your foundation has spent millions on an AIDS vaccine. You’ve experienced promising starts and a succession of disappointing trials. Do you still have hope?

BILL GATES: I don’t totally agree with the way you characterized it. … There’s about four or five different paths, each of which are showing very good results in monkeys.

Q: Your foundation sponsors contests soliciting novel ideas for difficult problems. You recently held one to create a sustainable toilet. How did that go?

BILL GATES: That’s absolutely a work in progress. We’re just going to stick with that until there is a toilet cheap enough to deploy in all the world’s slums and that has the same positive characteristics of a flush toilet. That is, it gets rid of the disease-causing agents and doesn’t create a bad smell. The flush toilet is one of those things where it works for the rich world, but the cost of plumbing all those slums and using all that water and processing plants, that’s not affordable.

There are a lot of failed projects in that area. I think there were like 12 entrants (in the most recent competition), and we gave four prizes. Now we’re back talking with those contestants about taking the best ideas and seeing if something can actually be deployed.

Q: In 2006, Warren Buffett committed $31 billion to your foundation. After his announcement, all three of you appeared on “Charlie Rose,” looking beyond happy.

BILL GATES: That was a fun day. You know, sometimes, when I come back to New York, I think about that day because it was an amazing thing … Warren had experienced a tragedy only a couple years before that. His wife had passed away. And that forced him to think about philanthropy. You know, Warren was thrilled about it. He made it fun. I gave him a copy of “The Theory of Moral Sentiments,” which is the Adam Smith book that predates “The Wealth of Nations.” It’s got the idea that generosity is sort of this inherent characteristic of mankind.

Q: So you don’t hold with Richard Dawkins about the “selfish gene”?

BILL GATES: Well, I believe in most things Richard Dawkins says. You know, one of my favorite books is Steven Pinker’s “Better Angels of Our Nature.” It looks at burning witches at the stake, genocide, slavery, violence — and how it’s gone down over time. And so there is an emergent fact that we’re treating each other better over time.

Philanthropy fits into that. Law fits into that. Improving living conditions … is certainly part of that. I don’t think there’s anything, when you get down at the level Dawkins is talking about, that contradicts this as an emergent property at the societal level.

Q: Bill, you’re a big reader. Do you use bound books or e-books?

BILL GATES: I’m still in the process of changing. Some books are so obscure that they’re not available in digital form. I like to annotate. To the degree I need a device, I need one where I can do the annotation in the digital format. They are getting better all the time. The e-books are easier for searching and things like that. So I’m in a transition where I use a real mix. Periodicals I mostly read online, whereas books, a lot of them, I still read on paper. Five years from now, those will be gone.

Q: A lot is made of the fact that you never finished college. People say, “You don’t need a degree — look at Bill Gates.”

BILL GATES: Well, I love taking courses, as much as anyone I know! Online. The Learning Company — I’ve done 30 of their offerings. … If people think I had some distaste for taking courses, they have the wrong impression. I was just in a hurry to be in on the ground floor of what the microprocessor enabled. It turned out I probably could have waited a few years, and Microsoft still would have been the pioneer. But my co-founder, Paul Allen, and I felt like we wanted to do it right away.

MELINDA GATES: And our three kids are getting the message that they should finish college. From both of us!

Q: About a third of your wealth is in the foundation, and more to come. Do you think your children might someday regret your generosity?

MELINDA GATES: The children already know our intentions. We talk about it in the house. They are very focused on where they are going to go to college, what their life might be after college. But they know that the vast majority of these resources is going back to society. And they’re OK with that. They know what our life’s work is. They travel a lot and they feel good about it.