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Dr. Susan Desmond-Hellmann says she had a “perfectly good job” when Bill and Melinda Gates came calling.

As chancellor of the University of California, San Francisco (UCSF), Desmond-Hellmann had piloted the school through both budget cuts and expansion, and she still loved the work.

But the Gates Foundation co-founders dangled a better offer: CEO of the world’s richest philanthropy.

“The more I spoke with Bill and Melinda, and the more I learned about the foundation and its mission, I found it very compelling,” Desmond-Hellmann said in an interview Tuesday. “I frankly felt like I couldn’t say no.”

When she takes the reins in May from current CEO Jeff Raikes, Desmond-Hellmann will be the first physician to lead the Bill & Melinda Gates Foundation — and the foundation’s first leader with no ties to Microsoft.

But her résumé, which includes a stellar track record in drug development and a stint doing HIV research in Africa, seems well-suited to the foundation’s efforts to improve health in the developing world.

“Sue’s background in public-health policy, research and development, and higher education make her an exceptional fit for this role,” Bill Gates said in a statement.

Before joining UCSF in 2009, Desmond-Hellmann earned a fortune and a reputation as a biotech innovator at Genentech, the San Francisco company that pioneered genetically targeted drugs. During her tenure as chief of product development, Genentech became the country’s leading producer of cancer treatments, with blockbusters like Avastin, for colon cancer, and Herceptin, used against some types of breast cancer.

That background in moving drugs from the laboratory to the marketplace could serve Desmond-Hellmann well as she takes on one of the foundation’s biggest challenges in the coming years: Ensuring that new vaccines, drugs and technologies actually reach some of the world’s poorest people.

“I can’t imagine someone who has more relevant experience,” said Dr. Robert Wachter

, professor and chief of the Division of Hospital Medicine at UCSF. “She understands drug development … and how to get drugs to the people who need them.”

At UCSF, Desmond-Hellmann also helped forge collaborations with the pharmaceutical industry, which has been a key — though sometimes reluctant — ally in Gates’ push for new and inexpensive medications.

“What I find frustrating is that when people innovate in the IT world, every innovation seems better and cheaper,” she said. “But our history in the health world is that every innovation seems better, but is almost never cheaper.”

Desmond-Hellmann, 56, got to know Bill and Melinda Gates by serving on the foundation’s science advisory board. Her husband, Dr.  Nicholas Hellmann, formerly served as director of the foundation’s HIV programs.

After finishing their medical training at UCSF, the couple spent two years in Uganda studying transmission of the virus that causes AIDS.

“I learned an enormous amount from that experience, not least of which is great humility about what I know and don’t know,” Desmond-Hellmann said.

With an endowment of $40 billion and more than 1,100 employees, the Gates Foundation has just weathered a period of rapid growth and reorganization overseen by Raikes, a former Microsoft executive known for his charm and management skill.

Under his leadership, the foundation narrowed its health focus to several key diseases, like malaria and HIV, but also broadened its emphasis on agriculture, family planning and other efforts to fight poverty.

Desmond-Hellmann will bring a winning personality to the job, along with the hard-nosed business perspective that ruffled some feathers in academia, Wachter predicted.

“She’s charismatic, she’s a very good listener, she’s a very broad thinker,” he said. She’s also not afraid of controversy, he added.

The Gates Foundation has come under fire for its support of genetically engineered crops and for the outsized influence it wields in education and global health.

Critics are also pushing the foundation to purge its investment portfolio of stock in companies like Coca-Cola and ExxonMobil, whose products and practices are seen by some as antithetical to goals such as improving nutrition and helping farmers cope with climate change.

As UCSF chancellor, Desmond-Hellmann found herself in a similar quandary when The New York Times revealed that her personal portfolio included a significant amount of stock in Altria, the parent company of cigarette-maker Philip Morris. She sold the stock and donated the proceeds to the university’s tobacco-control center.

Sandi Doughton at: 206-464-2491 or