The amazing ascent of Priscilla Chan

Priscilla Chan
Priscilla Chan
Image: Jessica Chou for Quartz
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When Priscilla Chan began her residency as a pediatrician at San Francisco General Hospital, she warned her attending physician, “I want to tell you up front: I’m a crier.” And cry she did. “When she’s feeling exhausted or overwhelmed, and sometimes when she’s really ecstatic, it’s just one of her ways of expressing,” says Meg McNamara, the doctor who received that warning and has since become a good friend of Chan’s. Today at the Chan Zuckerberg Initiative, where Chan is co-CEO, her tendency to cry is openly acknowledged. She has cried at all-hands staff meetings, at big public gatherings. There are tissues in all the conference rooms, colleagues say, just in case she needs one. She even cried at her first interview for this article, when discussing difficult aspects of her childhood.

Chan, 33, is among the most intriguing emerging leaders around, and not simply because she’s married to Mark Zuckerberg (who most definitely is not a crier). She is a doctor who has become a crusader. And don’t mistake her emotion for weakness. “There was this horrific fire, multiple kids getting burned really badly,” recalls Ryan Padrez, the chief resident who oversaw Chan’s pediatric trauma work at the hospital. “Priscilla was the first responder, at two in the morning, and she calls me on my phone, ‘Just start driving now, I’ll fill you in in the car.’ She was so calm under pressure, really quick thinking.” Chan became known in the pediatrics program “to have this black cloud,” Padrez says, “like whenever Priscilla is on, some bad stuff was going to happen. Luckily she had total capacity to deal with it.” One night when Chan was on duty alone, Padrez recalls, a mother gave birth in the parking lot across from the hospital to premature twins, just 25 weeks. “Priscilla is running the babies across the parking lot, they’re not breathing, they’re essentially dead unless she can bring them back to life.” Which she did.

Meeting Chan in person, you immediately sense her warmth—she’s as likely to hug as to shake hands. But she’s no pushover. Talking with Chan, you’re quickly aware of the incisive intellect that prompted her high school classmates to dub her “class genius” (and Harvard University to award her a full scholarship). This combination of openness and self-assurance has helped define the still nascent Chan Zuckerberg Initiative, which she launched with her husband in December 2015, via an open letter written to their newborn daughter, Max, and which she left medical practice to run fulltime.

CZI may be the world’s best-funded startup ever, with $45 billion pledged in that initial announcement, some 99% of the family’s wealth. As the day-to-day leader, Chan is overseeing an annual budget of $700 million to 800 million, pressing a transformation agenda as audacious as anything her husband’s creation, Facebook, has achieved. Among CZI’s goals: to help prevent, cure or manage all disease over the next century. (That’s right: all disease.) Oh, and at the same time, CZI wants to remake public education, pursue far-reaching immigration and criminal justice reform, and support affordable housing—all orchestrated by a newfangled organization that mixes philanthropic grant-making, venture investing, and the creation of new tech products in a way that’s never been done before. Already, they’ve disbursed $1.4 billion in grants and made $100 million in venture investments.

Mark Zuckerberg is among the best-known figures in America, and indeed the world. Chan has been more circumspect, reluctant to step into the limelight. Yet in hours of exclusive interviews over four months with Chan, Zuckerberg, CZI’s top leaders and more than two dozen other friends and colleagues, what becomes clear is just how central Chan’s influence has been on CZI, and on Zuckerberg himself.

“Priscilla grew up low-income, part of an immigrant family. She brings a very direct perspective on what it means to struggle, what it looks like to have inequity in an environment,” says CZI education adviser Jim Shelton. “Mark did not have that exposure.”

“Giving back has been part of my life before I even met Mark,” Chan explains near the start of our first conversation, in the Stuart Little conference room at a CZI office on Tasso Street in Palo Alto. “And then over the course of our life together, I was first in teaching and then in medicine. I kept seeing problems affecting children, students and adults. As a practitioner, there’s a fundamental lack of hope. There are solutions that exist out there, but they aren’t scalable and replicable. So what if we take that lens of a frontline practitioner, if we take the tool set of building technology, what niche might we be able to fill in the world of actually making social impact?”

Mark Zuckerberg and Priscilla Chan announce CZI Science at a news conference in 2016. Among CZI’s goals: To help prevent, cure or manage all disease over the next century.
Mark Zuckerberg and Priscilla Chan announce CZI Science at a news conference in 2016. Among CZI’s goals: To help prevent, cure or manage all disease over the next century.
Image: Reuters/Beck Diefenbach

CZI is very much a joint Mark-and-Priscilla operation. They are technically co-CEOs (their actual titles are simply co-founder), and have a weekly one-on-one strategy session at their home on Thursday afternoons, often followed by dinner with CZI-related guests; on Friday mornings they run an all-hands meeting at the CZI office and meet together with their leadership team. Strategy is set jointly. Yet on a daily basis Chan is the one in the office, making on-the-ground funding, staffing, and operational decisions while Zuckerberg tends to the task of running his high-profile public company. Her management style is open and warm; she banters playfully with staffers about everything from new coffee shops to conservative veganism, and staffers are comfortable enough to share their tears with her too. She is also a voracious learner, devouring briefings her staff prepare for her. During meetings, she begins in the pose of a listener and then quickly breaks in with questions, in a Socratic search for weaknesses and answers.

The team at CZI seems almost willfully oblivious to the elephant in the room: Facebook. Looming over Chan’s efforts is the suspicion among critics that CZI’s do-good mantra is a whitewash effort by Zuckerberg, to distract attention from the intense controversies around Facebook. “We’re two different organizations,” Chan says flatly. “We are unrelated.” Some CZI supporters stress that CZI was launched when Facebook and Zuckerberg were riding relatively high in the public and political zeitgeist. “If this were just for PR,” says David Plouffe, who oversaw Barack Obama’s presidential campaigns and now runs CZI’s policy and advocacy efforts, “there would be much faster, easier ways to get impact. I could do that in a day.”

Still, as Plouffe acknowledges, “there’s the overhang of Facebook.” It’s one of many challenges that Chan and Zuckerberg are navigating as they balance CZI’s hyperbolic ambition, a CZI roadmap that is literally decades long, a new young family (two daughters under three years old), and their own relationship, both personal and professional. Given their enormous wealth and the many years ahead of them, how all this plays out could have implications that extend far beyond one couple and one company. And there is no better prism to glimpse what the Zuckerberg family aspires to—and to understand Chan’s impact—than through the ongoing evolution of CZI.

Confessions of a power couple

“I probably pushed on the work-life balance,” Mark Zuckerberg tells me. He is seated at a conference room table in a CZI office, next to his wife. “When you’re doing a partnership like this,” he goes on, “it’s important to set aside time for your personal partnership.”

Whether it is the CZI setting or the fact that Chan is at his side, Zuckerberg is noticeably at ease, especially given how on-his-guard he’s been during recent media exchanges. (This was before Facebook’s admission that 50 million user accounts had been hacked.) Wearing a blue long-sleeve t-shirt, occasionally glancing Chan’s way, Zuckerberg explains that initially the two of them hadn’t planned to have Chan run CZI day-to-day; indeed, they weren’t planning to have anyone in that role.

“We’d had an education initiative,” Zuckerberg says, referring to Startup Education, a nonprofit they set up years earlier. “We were already doing immigration reform. We viewed CZI as a way to bring in more experienced senior leadership, but we thought they were going to be independent initiatives.”

Chan is patiently waiting for her turn to join in. Zuckerberg says that it was only as their strategy evolved—“that we’re going to use technology as a big lever to create change across all these different areas”—that they decided they needed someone to coordinate it all. He pauses and Chan, casually dressed in a black top, speaks up. “If it was going to be just a grant-making organization, it would be easy to set things up and just check in once a quarter,” she says. “But once you’re building engineering and advocacy and all these things together, it really does need to be one organization.”

“We had a search going [to hire someone],” Chan goes on. “But there was no one perfect. And then once I had August”—their second daughter, born in August 2017—“I came back and was like, ‘You know what? We’re closing the search. I have an opinion on how this is going to go.”

CZI is like no other organization or philanthropy anywhere. It begins with the founders’ relationship, straddling their personal and work lives, but it also includes CZI’s structure, an amalgam of old parts (like the former StartUp Education) and new, still evolving pieces. CZI is not technically a foundation, though it has one subsidiary that is a 501(c)(3) nonprofit and makes charitable grants and another that is a 501(c)(4) for advocacy. It also has a venture-investing arm, plus about 125 engineers, data scientists, and other tech experts working to build software products. Legally, CZI is a limited liability corporation; this gives its founders great flexibility in how they operate. (During a product update meeting, Chan drilled in with questions about a wide range of potential financial partners for the project—from big banks to corporate investment funds to foundations—as well as which part of CZI would provide resources to spur the venture.)

Listening to the co-CEOs talk together about the genesis, philosophy, and operations of CZI, you can see how their two personalities feed different aspects of the organization. It’s impossible to discern a first-among-equals status in their partnership. Chan is quick to acknowledge Zuckerberg’s deeper business expertise. “It’s helpful for me to pattern-match from Mark’s experience,” she says. “The first time I see a problem, to use a medical analogy, I’m never clear if its fatal or what the natural course of the illness is. Is this the most terrible thing that’s happened? And Mark is like, ‘No, it’s going to be fine.’” At the same time, Zuckerberg repeatedly turns to her as we talk. “We come at the work from different perspectives,” Zuckerberg says. “I might be focused on tools that we’re building, and you might be more focused on how our organization works together [with partners]. There are definitely things that we disagree on, and we just talk a lot.”

If Zuckerberg is the admired business-tech guru, Chan provides the cultural glue for CZI, an inspirational figure whose empathy and humility CZI staffers refer to repeatedly. “It’s not a hierarchy,” Chan says of her working relationship with Zuckerberg. “We have to walk the balance of our decisions. Do we talk about [a disagreement] in front of the team or do we talk about it at home or in our one-on-one sessions and come in as a united front? Because sometimes it is instructive for the team to see where we disagree but sometimes, if it’s controversial, we need to resolve this between the two of us, like there’s no light between the two of us. It’s a balance.”

Zuckerberg and Chan in Berlin, Germany in 2016.
Zuckerberg and Chan in Berlin, Germany in 2016.
Image: Reuters/Kay Nietfeld/Pool

When I share with Zuckerberg one source’s assertion that he was initially surprised at how good Chan was at running the organization, Zuckerberg replies, “I’m not surprised at anything she does.”

“There aren’t many examples of co-leaders working together successfully, but we know each other really well,” Chan says. “Yes, I’m here day-to-day, but I know what Mark cares about and how to surface that. We have very open feedback. This morning, Mark was like, ‘Here are things I think we’re missing,’ and I was like, ‘Let’s do it, I agree.’ It was a total blind spot to me. We are intellectual partners.”

“When we started out,” Chan continues, “there was a degree of, we’re husband and wife and ‘I don’t like the way you said that thing.’ But at this point, we have a different relationship, we have the ability to engage on these topics.”

“We used to go out to dinner to talk about CZI one night a week,” Zuckerberg says, “but that felt weird over time, because we also go out on dates. I just think psychologically, you want to have different places. So now we carve off time, like our one-on-ones. And then when we’re at the kitchen table with our kids, it’s not like we’re not talking about what’s going on in our lives—that’s weird too, you’re not going to turn things off that are important and emotional—but we try not to go through logistics and details and stuff like that.”

I ask Zuckerberg at one point how seeing the world through Chan’s eyes has changed him. He glances at her, and then fumbles a bit for his words, telling a story about how she pushed him to volunteer at an after-school program for underserved kids so he could gather more direct experience. Midway through, his thoughts crystalize: “Priscilla’s family story is amazing, it’s an inspiring thing for all of us. You see what’s possible when people have opportunity and you level the playing field.”

Life before Mark

When Chan was in seventh grade, she was a victim of bullying. “I never went to recess,” she says. “I would eat lunch and then just wait in the bathroom until it was over. All year. No teacher ever noticed.”

This is just one of many episodes in Chan’s childhood where she felt vulnerable and powerless. A first-generation American, she grew up in Quincy, Massachusetts, a working-class suburb of Boston. Her parents were ethnic Chinese who came to the US from Saigon, part of the wave of refugees known colloquially as Vietnamese boat people. “You literally put your children on a boat, say goodbye, and hope to meet them on the other side,” says Chan, who was raised speaking Cantonese. “There are horror stories of families putting all their kids on one boat and it sinks, they lose their children. Both sets of my grandparents, who were in the same community, paired their kids, so if a given boat sank they’d only lose a kid each, which is a crazy calculus. My mom and my aunt were paired together and became best friends. And that’s how my mom got to know my dad. They got married later on.”

Chan, who calls herself a science nerd, found her cohort as a high schooler in robotics class—and ultimately as part of the tennis team. “She’d never played a sport before and was not a talented athlete,” recalls her coach, Peter Swanson, who was also her science teacher. “But she worked hard and liked playing.” The school itself was run down. “I used to tell the kids, ‘Welcome to the city dump’,” says Swanson. “The ceilings leaked, the walls were falling apart.”

The tennis team, which competed against more affluent districts, literally shoveled snow off outdoor courts so they could practice. (Chan didn’t just shovel: She once helped her teacher/coach thaw out a frozen spigot early one morning, so they could hold their annual car-wash fundraiser. “She told me, ‘Just blow on it, you’ve got a lot of hot air,’” Swanson recalls.) In her senior year, Chan was named tennis team co-captain, even though she remained a middling talent. “She knew how to motivate,” says Swanson. When the state tournament was scheduled for the morning after the prom, Chan convinced her teammates to skip the dance.

Chan’s talent as a student was even more evident. When she took AP environmental science as a sophomore, her classmates struggled so much that the school restricted the class from sophomores in future years. But Chan got a 5, the top score on the test. She graduated as valedictorian.

At Harvard, Chan says, she quickly recognized how lucky she was to be there. “I looked around and thought, ‘I’m not like these kids. I come from a totally different background.’” That sense was reinforced when she volunteered to tutor underserved children and felt a kinship with their obstacles. “I came from a family that didn’t have the resources, didn’t have the opportunities, didn’t have the connections.” She tears up when she recalls those kids, her feelings as fresh and motivating as ever.

Priscilla Chan, photographed in Palo Alto.
Priscilla Chan, photographed in Palo Alto.
Image: Jessica Chou for Quartz

Chan says she became dedicated to evening the scales for others, to pay forward the gifts that she felt teachers like Swanson had bestowed on her. She calls her commitment “field agnostic, as long as I get to spend time with children.” Her first job out of Harvard was as a middle-school science teacher. (She seems almost embarrassed that it was at a private school for gifted students.) After medical school, she became part of a special leadership program for pediatricians dedicated to helping underserved families. She even started a school, called The Primary School, in economically strapped East Palo Alto, that combines education and health care, seeking to address the interplay between social issues and academic success. (Costs are funded by CZI.)

Chan says she and Zuckerberg (who met each other in line for the bathroom at a frat party her freshman year at Harvard) first talked about giving back when she was still at Harvard, after Yahoo offered Zuckerberg $1 billion to buy Facebook. “It was the first opportunity to be like, wow, we can make a big impact,” Chan says. “He made the decision to continue building the company, but we started brainstorming. What could we do if those resources were a reality?”

How to spend $45 billion

To understand where Chan and Zuckerberg are taking CZI, you have to go back to Newark, New Jersey. Because even though they downplay the connection, Newark set the stage for everything that has come since.

When Zuckerberg announced a $100 million pledge to the Newark public schools in 2010, he did so on television, during an appearance on The Oprah Winfrey Show, flanked by then-mayor Cory Booker and New Jersey’s former governor Chris Christie. The Newark effort was supposed to set a new standard for public education but instead was dogged by tales of waste, opportunism, and miscommunication.

“There was a lot of criticism,” recalls Chan. “You make this big splash and then in two years, or whatever, they decided it was failing. But those same [critics], they were the ones who first thought it was going to be a silver bullet.” She continues, “We definitely jumped in headfirst. Smart people were telling us this was a reasonable thing to do. We said, let’s do it and figure out and learn, start somewhere. There are different ways we could have started, but overall I’m positive on what we’ve done, people we’ve met, systems we’ve gotten acquainted with.”

That emphasis on learning undergirds everything that Chan, and CZI, do. For one thing, CZI’s public posture has been relatively quiet. When in September 2016 Chan and Zuckerberg together announced the launch of CZI Science—a $3 billion commitment—they did so not on television but in an auditorium on the Mission Bay campus of the University of California at San Francisco (UCSF), where Chan did her medical training. And Chan and Zuckerberg have been careful to temper expectations: While Newark was positioned as an effort to remake not just the city but the whole model of public schools in just five years, CZI is framed as an experiment that will continue for 50 or 100 years. “We need to be patient,” Chan says. “It’s going to take some time. That lesson is really ingrained in CZI’s DNA.”

As for “jumping in headfirst,” that too has been modulated. Chan and Zuckerberg spent two years talking with Nobel scientists, leading educators, foundation chiefs, and other philanthropists before announcing CZI, gathering information and insights about how they could most effectively and distinctively put their money to work. They had Bill and Melinda Gates over for dinner in early 2013 (they made pizza together) and have continued to rely on them as sounding boards. They did video conference calls several nights a week, with experts all around the world. Meanwhile, Chan was working with underserved families as a physician at San Francisco General Hospital, gathering on-the-ground experience. They knew they would be taking risks with their new venture, whatever course they took, but they were determined that these would be informed risks, supported by a philosophy that they both agreed upon and embraced.

CZI’s robust ambitions grow in part out of Chan’s perspective as a medical practitioner. “Stay close to the problem” is a mantra that is often repeated in the halls of CZI. “[Chan] doesn’t want us just talking to ‘the fancy people,’” says Cristina Huezo, who runs CZI’s newly created Community Fund, dedicated to supporting health, education, and social-outreach organizations in underserved Silicon Valley communities. “You know, the executive directors, head of boards. She wants us talking to the real people, the people who actually get served by the organizations.”

CZI similarly leans into Zuckerberg’s aptitude for technology. If there is a philosophical difference between CZI and the Gates Foundation, it is the belief that using technology to create tools for scientists, schools, and others can be that silver bullet for social change over time. That’s why CZI has been hiring engineers at a steady clip, as well as wooing prestigious biologists and partnering with education reformers.

“We’re a complicated organization,” says Plouffe. “We’re trying to mesh all these different disciplines in a way that turns into an orchestra. They are eager to experiment using all the tools in the toolbox. How do you make sure that you don’t take any piece of weaponry off the table? It could be investing, it could be advocacy.”

“The big mistake CZI could make is that we are too unfocused, working on too many things,” Plouffe continues. “How does this ladder up to our strategy? And are we the best people to do it? We’re going to have to say no to a lot of great things. The question is, where can we accelerate progress or tackle something that no one else is tackling?”

This burden, on a day-to-day basis, now falls on Chan. At a CZI all-hands meeting in late June, she challenged the team, Plouffe recalls: “’Are we being daring enough?’ One of our core values is to be daring and humble. That includes a willingness to go big and fail. If we’re just doing the same stuff that others can do, that will be a real tragedy.”

Philanthropy under the microscope

The early days of CZI resembled those of any startup: a handful of eager true believers crammed into an inauspicious locale. For Chan, that was a two-room office in Menlo Park above the comically named Hoot N Toot dry cleaner. “I assembled furniture, got really good at it,” she says.

What’s different, of course, were the vast resources just waiting to be deployed. Today CZI’s operations are spread out among multiple offices in Palo Alto as well as a new headquarters in Redwood City that opened this summer. More than 250 people work on projects divided among three main categories: science, education, and what CZI calls “justice and opportunity,” which is Plouffe’s policy and advocacy realm and spans immigration, housing, and criminal justice, as well as the local grant-making that CZI does in and around San Francisco.

That $3 billion that CZI pledged to science in 2016? Some $600 million is dedicated to a 10-year experiment called the Biohub that brings together researchers from UCSF, Stanford, and Berkeley. On a recent tour, I was taken through well-equipped labs with rows of sequencing machines and an entire room that’s been set aside to test out how automated visual and diagnostic tracking of individual experiments might be built into a testing facility. Biohub co-president Joe Derisi, who gave me the tour, also shared with me the output of new microscopes that the Biohub has developed, which combine software and imaging advances that allow a new level of detail at the cellular level. It was pretty awesome.

“They are self-driving,” he explained. “Imagine 22 focus knobs that all have to be changed in relation to each other a thousand times a second. You can’t do that by hand.”

Derisi stresses that the Biohub is not part of CZI. Everyone gets confused by that, he says, though the confusion is understandable. The science research center is named the Chan Zuckerberg Biohub, the bulk of its funding comes via CZI, and CZI software engineers are literally on site to contribute. It is a quintessential example of Chan and Zuckerberg’s willingness to embrace new structures and approaches. “Our hypothesis,” Chan explains, “is that we could build a strong engineering team that doesn’t exist in science.”

CZI wants to help create the kinds of tools that can advance science and medicine but aren’t being funded elsewhere (often because there is no near-term revenue opportunity, as an individual drug might have). Case in point: 18 months ago, CZI purchased a Toronto-based engineering firm called Meta that uses AI to glean intelligence from the roughly 4,000 research papers released each day by scientific journals and academic labs around the globe. Meta had been structured as a for-profit operation—and initially came in contact with CZI looking for venture investment—but Chan and Zuckerberg decided to buy it outright, shut down its commercial efforts, and focus entirely on building a philanthropic-supported, freely available tool.

“Our team has almost doubled since we joined,” says founder Sam Molyneux, who like most of the Meta crew is now based in the Bay Area. “We’re working with thousands of researchers, building a personalized experience for scientists to be able to understand new research being published anywhere in the world.”

Meta, like the Biohub, is an experimental effort still in its early days—unlikely, on its own, to spur the end to all disease. What these projects offer is a window into how CZI aspires to have an impact, in a time frame measured not in months or even years, but over decades. The science effort that Chan spoke most to me about, even inviting me to sit in on a meeting of a special scientific advisory board, is a broadly dispersed global campaign to create what’s called the Human Cell Atlas. When Chan and Zuckerberg heard about this research, they say, it immediately connected with them as the type of long-term, basic science that could have huge ramifications for our understanding of disease. As CZI Science chief, Cori Bargmann, explains it, the human body has perhaps 10,000 different kinds of cells, but there is no overall catalog that identifies each kind, where it exists, what its normal and variant features are, and other such details. Scientists around the world are now working to create an atlas of this information—a massive, detailed database of human cells—in hopes of unleashing a new wave of discovery. CZI has stepped in as both a funder and, again, an engineering resource to help facilitate and speed the creation of this tool.

That word, speed, has so much to do with CZI’s operational assumptions. Chan and Zuckerberg are committed believers that near-term efforts can help accelerate the pace of scientific discovery—just as the decoding of the human genome did. Several CZI leaders note the example of the same-sex marriage movement as a parable for their efforts. “You don’t want to be involved in marriage equality in 2015, when it’s clear that it’s going to happen,” as Bargmann puts it. “You want to be involved in 2003, when it looks completely impossible.”

Eyes on education

When Mark Zuckerberg first visited one of the Summit charter public schools, “I kept saying to him, ‘Feel free to go talk with the kids,’” recalls Summit founder Diane Tavenner. He demurred, “I don’t want to bother them,” he told her. Chan’s first visit, says Tavenner, was the opposite. “She just sits down with the kids and starts asking questions, chatting away.”

Despite their different styles and comfort with kids, both Zuckerberg and Chan were similarly taken with Summit’s software, which helps teachers offer personalized education to a classroom of students. (Chan, who visited first, texted Zuckerberg 15 minutes into her tour that he needed to see it himself.) “[Zuckerberg] was fascinated by the technology,” says Tavenner. “He said, ‘We’d love to meet the engineering team,’ and I said, ‘Oh, you mean Sam?’ He’s like, ‘What? Your whole system is running on this, and you have only one engineer?’”

Chan and Zuckerberg initially visited Summit in 2014, before CZI had even been announced, when their education efforts were housed in Startup Education, the entity spawned from the Newark grant. While Summit operated a network of a half-dozen public charter schools, its ultimate goal was for its software-supported personalized learning approach to be shared everywhere. The problem was, they had neither the finances nor the technical resources to scale their program for others to use. Zuckerberg ended up peeling off a group of engineers at Facebook to be “seconded,” in Tavenner’s language, to Summit. That role was eventually transferred (along with a bunch of the engineers) to CZI, which has helped Summit expand its network to 13 locations and share the Summit Learning Program with 300 other schools.

CZI isn’t restricting its education work to just schools. Vivian Wu, who began working with Chan and Zuckerberg even before the Hoot N Toot days, has been making CZI venture investments in for-profit companies that the team believes can accelerate the innovation cycle. “For-profit companies can potentially scale high-quality solutions much more broadly,” Wu says, “because you are not purely reliant on philanthropic dollars.” Among the ed-tech investments: Byju’s, a personalized learning app in India which has 750,000 paid subscribers in 1,800 towns, and Andela, which is working to train the next generation of developers in Africa by pairing under- or unemployed young people in four-year fellowships with companies like Microsoft and Google (and, yes, Facebook). It’s not that these investments aren’t supposed to deliver enough financial return to be sustainable, Wu notes, but in the big picture “venture should be a tool in achieving our impact objectives. It is a tip of the spear. Venture allows us to leverage other entrepreneurs. And they might teach us about new areas that we’re not focused on yet on the program side.”

If the breadth of CZI’s reach is beginning to get dizzying, hang on because there’s more. CZI has also backed a broad range of social-action partners, including criminal justice reform outfit Just Leadership USA, which led the effort to close the notorious Riker’s Island jail in New York City and received an $8 million CZI grant. “We just went in there big, because they had so much momentum,” explains Plouffe. “People from the traditional foundation world were like, whoa! But Priscilla said, ‘I get that this is different than the playbook shows, but we want to be nimble, opportunistic, not be bound by conventions.’”

Another example: Earlier this year, CZI committed engineering experts and other CZI staff to work directly with the Philadelphia district attorney’s office to upgrade local prosecutors’ tech and data systems. Among other things, the CZI team “will shadow attorneys, criminologists, operations leads and administrative staff,” as the project announcement put it, in an effort to identify more equitable processes and barriers to implementing change.

Surveying this broad field, you start to understand why Chan felt compelled to step away from medical practice 18 months ago—she has the date, March 17, 2017, fixed in her head, her last day of clinical practice—and now focuses her attention full time on CZI. (She is also bringing on a CEO to run The Primary School, a role she had been filling personally.) “I love my patients, I love being part of a family, getting to know them. And I also love the physiology, understanding how breathing works, the science and the deep touch you have with a person when you’re really caring for them. But right now, it’s like the trolley problem, the good version: Do you help 100 people very deeply or do you try to make the world better for everyone?”

The shadow of Facebook

Late this summer Chan and Zuckerberg shared a laugh with a friend over a cartoon in the New Yorker. “There are two people in a Back To The Future car,” says Chan, “and it’s in a dinosaur’s mouth. And the caption says, ‘At least we got out of 2018.’”

It certainly has been a challenging year for the Zuckerbergs, with Mark testifying before Congress, Facebook hammered in the press daily, a 20% stock plunge on a single day in July after a disappointing earnings report, and most recently, a massive data breach. On the other hand, the Zuckerbergs did get to enjoy the CZI summer picnic at a neighborhood park with their kids. “There were bouncy houses, face painting, a puppet show,” says Cristina Huezo. “Priscilla had one daughter on her hip, and was chasing the other one around.”

There have been other humorous moments this year for the family, like the time they got a call from the Jewish preschool that Max attends, gently chiding them about sending Max in with a ham-and-cheese sandwich for lunch. Or the time that Mark decided Max should learn to code, only to admit that two-year-olds should probably start with more basic skills.

Like many young parents, they have some naivete about child-rearing. Despite the fact that Chan is a pediatrician herself, she says she will sometimes turn to her kids’ doctor for parenting advice. “I asked our pediatrician, can we talk about work in front of our children,” Chan says. “We want them to be exposed to the types of issues [at CZI], but I don’t want them feeling like there’s a lot of disorder in the world. And the pediatrician’s advice was, it’s fine to have those conversations, just take it to its logical conclusion so they see that conflict gets resolved.”

CZI too may be infused with some naivete, though it is harder to identify where. As with parenting—a decades-long endeavor of constant learning—their managing of CZI will become more sophisticated over time, a fact they readily acknowledge. “We’re not at the end of our lives giving away capital,” Chan says. “We’ve made an investment to decide to run this place ourselves. That’s a proactive choice, a deliberate choice.”

Chan may be naïve too about the shadow that Facebook casts over her team’s effort. Her husband’s company—the source of the capital that CZI relies on—has been derailed by the consequences of various decisions, tumbling from its pedestal as a breakthrough utility to becoming the default example of what can go wrong for a tech company. Zuckerberg and the Facebook team are scrambling furiously to correct course, but skepticism far outweighs support in the public eye. CZI could well hit its own potholes, or get caught up in the maelstrom of noise and doubt, limiting its ability to reach toward its own audacious ambitions. Indeed, CZI’s resource pool moves up and down with fluctuations in Facebook’s stock price (though to this point, the direction has been largely up, with their initial $45 billion contribution now worth an estimated $61 billion). And the fact that several former Obama administration officials work at CZI could complicate Zuckerberg’s dance with Republican legislators in DC, already suspicious of Facebook’s claims of nonpartisanship.

If there’s anything Chan and Zuckerberg know for certain, it’s that the critics and naysayers will continue to speak out. And they’re not going to cry over that—not even Chan. “Our skin has gotten pretty thick,” she says. “The future is coming. You realize that you want to have this incredible world for your children. And we knew we had an opportunity to be part of creating that incredible world. But time was ticking, and we should get started.”