SEATTLE -- The annual letter from Bill and Melinda Gates usually paints a rosy view, with carefully curated success stories from the battle against global disease and poverty, and praise for new technologies backed by the Gates Foundation.
But for this year, the co-founders of the world's richest philanthropy have instead opted to answer a selection of critical and skeptical questions about the foundation's work and the power it wields.
Among them: "Why don't you give more in the United States?" "Does saving kids' lives lead to overpopulation?" And "Is it fair that you have so much influence?"
The Gateses also address the impact of President Donald Trump and his policies, a topic about which both have been largely circumspect.
"I believe one of the duties of the president of the United States is to role model American values in the world," Melinda Gates wrote. "I wish our president would treat people, and especially women, with more respect when he speaks and tweets."
Bill Gates said he's concerned by Trump's focus on "America First," and his proposal to slash foreign-aid funding. "The world is not a safer place when more people are sick or hungry," Gates wrote.
Although the Gates Foundation has worked with every presidential administration since its founding, Bill Gates said they "disagree with this administration more than the others."
On the question of philanthropy at home, the Gateses acknowledge that the $500€‰million they spend in the United States each year--mostly on education--pales compared to the $4 billion the foundation spends in developing countries. That reflects the foundation's conviction that it can save more lives in poorer countries, where investments in simple solutions like vaccines can have big payoffs.
But the Gateses also say they are looking for ways to expand their work in the United States, particularly to help people move up the economic ladder.
Last fall, the couple who are better known for visiting villages in Africa and India took a trip to Atlanta to learn more about the lives of poor Americans. Residents of an apartment complex pointed out mold growing on the walls and explained how they hide their children in the bathtub when gunfire breaks out. A single mom describedhow she was evicted from her apartment while in the hospital with her newborn son.