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The Rockefeller Foundation’s Rajiv Shah on How To Tackle the World’s Biggest Challenges

There’s an endearing scene early in Rajiv Shah’s new book, Big Bets. It’s 2010, and he has just been sworn in, at age 36, as head of the multi-billion-dollar U.S. agency that oversees humanitarian and development aid around the world. Hours later, the devastating 2010 earthquake in Haiti occurs. As Shah walks into the Oval Office for a meeting on the response, he sees President Obama and then-Vice President Joe Biden, backs turned to him and looking out the window. “Are we sure about putting this guy Raj Shah in charge of this?” he overhears Biden say.

Shah forges ahead, working with others inside and outside the government–a lesson in embracing partnerships and one of many chapters in a remarkable career. The son of Indian immigrants (his father practiced English listening to Ronald Reagan speeches), Shah went from medical school to corralling heads of state as a young staffer at the Bill and Melinda Gates Foundation and today leads the Rockefeller Foundation, one of the world’s oldest and largest nonprofits. His book, subtitled “How Large-Scale Change Really Happens,” is part memoir and part clarion call for all of us to think more ambitiously–and optimistically–about tackling the planet’s challenges.

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This conversation first appeared in Time on October 15th.