I suspect that one cause of this is that super wealthy people are often owners of a business. Their money is tied up in what made them wealthy emotionally as well as politically. For instance Buffet was wealthy in Berkshire-Hathaway shares. He recently started contributing significant portions of his wealth to charity because he no longer felt that he needed those shares to retain control. On another point, while Gates Foundation is not nearly as visionary as I would like they are not a traditional charity either from what I have seen. They tried to identify the best place to save lives (in the short term) with money, and started there. They have a good statistical grounding.
While the Gates Foundation may not be flashy or romantic, they do seem to be pragmatic- which in the end is probably a lot more helpful for actually helping the maximum number of people.