Jeff Skoll had been working frenetically with epidemiologists, NGOs and diplomats for weeks last fall. The experts were racing to contain the wildfire spread of Ebola, only to have their benefactor, the California billionaire and media mogul, suddenly suffer his own collapse. An intestinal wrecking ball sent Skoll reeling. His fever spiked to 105, knocking him flat on his back. “I just had to close my eyes for eight days,” he recalls, “and hang on.”

Skoll, already slight in build, lost 10 pounds to what doctors diagnosed as yellow fever, perhaps contracted from Ebola caregivers. For the introspective Canadian, facing his own mortality on the brink of his 50th birthday, the medical crisis seemed to be a sign: The time had come to reassess his 10-year-old entertainment company, Participant Media, to ensure its sustainability for the long haul.

“This was part of my wake-up call,” Skoll says of his debilitating illness. “At Participant, I am the board. I am the sole greenlight at the company. If something happened to me, that would be a problem.

Terence Patrick for Variety

During a rare and wide-ranging interview at his Sunset Boulevard office, the soft-spoken Skoll divulged plans to push ahead with a long-stalled initiative to appoint a board of directors for the Beverly Hills-based maker of films, television and new-media content. In recent weeks, he hired consulting firm McKinsey & Co. to conduct a top-to-bottom strategic review of his operations. And he acknowledged that he needed to decide whether his nascent television enterprise — the cash-draining Pivot cable channel — could be kept alive as a stand-alone.

When Skoll launched Participant in 2004, doubters had questioned whether his super-sized dream — marrying bottom-line profitability to high social impact — could succeed in the real world.

With a boyish guilelessness, Skoll already had taken pleasure in proving nonbelievers wrong — and made a considerable fortune doing so. He helped launch a Silicon Valley startup on the belief that strangers would trade goods online for cash. When he retired from eBay as the e-commerce company’s first president at 36, he had silenced the skeptics. And he’d made $2 billion.

The initial shrugs, and even eyerolling, that greeted Skoll’s arrival in Hollywood eventually gave way to admiration for the media magnate’s sincerity and smarts. Participant helped finance some films that were both commercially viable and socially relevant — including Oscar-winning climate-change documentary “An Inconvenient Truth” and a trio of best-picture nominees, “Good Night, and Good Luck,” “The Help” and “Lincoln” — and backed them with education and social-action campaigns on its crusading website.

Walt Disney Studios chairman Alan Horn describes Skoll as “a fully formed human being,” unmoved by celebrity, the usual Hollywood trappings or the prospect of greater riches. After meeting Skoll a decade ago, Horn says: “I found myself thinking, ‘If anybody on this planet is going to have a lot of money, let it be a person like him.’ I liked his values. I liked his priorities. … I liked his humility and I liked his intelligence.”

But inside his entertainment company, Skoll — who in 2013 publicly proclaimed his intention to make Participant “the most important media company in the world in terms of impact” — expressed frustration. At an internal meeting last summer, according to some of those present, Skoll wanted to know why Participant hadn’t made a bigger mark in TV. He pressed for the company’s TakePart website to do more. And overseas subsidiaries needed to be launched more quickly. Over and over, his executives in the room recall him saying: “This thing is broken. It’s broken.”

Skoll readily acknowledges that the privately held Participant has not yet turned a profit. But he pauses when confronted with accounts of the company’s confidential gathering, saying the remarks need to be put into context.

“We have done super on our film business and our brand in the Hollywood entertainment community,” Skoll says. “I felt there were a (few) things that really needed attention. One was international expansion, the other was our approach to digital and … we are not spending any time on consumer branding. I felt those things were off track.”

And, he adds, “I’m impatient to see the future as soon as possible.”

Participant’s arrival at this crossroads does not come as a surprise to anyone aware of Skoll’s tentpole-sized ambitions.

When he left eBay in 2001, his fortune made, he also had a conviction — lingering since his bookish teenage years — that the world faced grave threats. So he began to build organizations to address war, famine, disease and nuclear proliferation: the Skoll Foundation, the Skoll Global Threats Fund, the UCLA Skoll Center for Social Impact Entertainment and his “values-based” Capricorn Investment Group.

But he views a foothold in entertainment as playing an especially crucial role in his vision of telling stories about the world’s greatest challenges. He entered the industry in 2002, investing in start-up Ovation Entertainment. But rather than make world-changing films, the modest production company generated a couple of clunkers, low-lighted by the Robin Williams-starrer “House of D.”

Skoll rebooted in late 2003, taking offices on the Sony lot and working closely with new advisers — Hollywood insiders Peter Schlessel and Rick Hess, the CAA agent. Still, some industry regulars thought the newcomer might be another super-rich dabbler, cozying up to starlets, making a film or two, then disappearing.

But Skoll determined his new venture would be unique. Announcing its formation the following year, he said Participant would not just provide entertainment but battle “against injustice and bridge the gulf between haves and have-nots.”

One studio chief called the idea of a do-good entertainment company “cute,” while others tried to push the startup into making big action movies, recalled Skoll’s then-top lieutenant, Chris Adams. One filmmaker’s pitch seemed hopeful: a picture about a small health-care entrepreneur battling a corporate titan. “You know what the movie was?” Adams recalled. “It was ‘Dodgeball!’ ‘Dodgeball!’ I said, ‘Nice try, guys, but no.’ ”

Skoll says those making the offers didn’t much care about his mission. “Some of them didn’t get it, or didn’t want to get it, or had films that had no social relevance, but would be happy to take the money.” He notes his prospects quickly turned when Horn, then the president of Warner Bros., invited Participant to partner on a pair of issue-driven narrative pictures, the Middle East-set “Syriana,” and union-centric women’s rights film “North Country.”

Terence Patrick for Variety

Both went on to critical acclaim, with “Syriana” earning a supporting actor Oscar for George Clooney, and “North Country” garnering nominations for Charlize Theron and Frances McDormand. More importantly for Skoll, “Syriana” led to his meeting Clooney. “He walked me through ‘Good Night, and Good Luck’ shot-by-shot,” Skoll recalls. “It really wasn’t entirely on the page at that point. But George is a talent. I said, ‘I’m in.’ ”

On first hearing Skoll’s plan to make money on socially relevant films, Clooney recalls thinking: “Good luck with that. We’ll see you on PBS.” But, the actor adds: “He actually showed up and did exactly what he said he wanted to do. That’s a pretty rare story in Hollywood.”

Clooney directed, co-wrote and acted in “Good Night,” about TV newsman Edward R. Murrow’s successful 1950s battle to end Sen. Joseph McCarthy’s reign of ideological terror. The film was nominated for six Oscars, including best picture, and is one of 67 films — about half of them documentaries — that Participant has helped finance. Collectively, they have been nominated for 37 Academy Awards and won eight, including the docu prize this year for Laura Poitras’ “Citizenfour,” about whistleblower Edward Snowden.

Participant has also invested in a fair number of box office duds over the years, including “The Beaver,” “Furry Vengeance” and “The Fifth Estate.”

And, there have been the usual regrettable passes. Skoll knew Ben Affleck from the actor-director’s charitable work in the Congo. Affleck asked Participant to back “Argo,” but Skoll already had said yes to Steven Spielberg’s “Lincoln,” and felt his company didn’t have the capacity to do both films. “In retrospect, I wish we had,” Skoll says. “Lincoln” lost the top Oscar to “Argo” in 2013.

But Participant measures the success of its films not just by the awards they win, but by the number of viewers they move to action. It carves out a symbiotic niche and prolongs the shelf life of its content, largely through its TakePart website. Via the site’s vertical tie-ins, for instance, the audience for docu “Last Call at the Oasis” can find ways to support water conservation on the Colorado River, and viewers of the biopic “Cesar Chavez” can discover whom to call to demand better working conditions for farm workers. The social action unit has screened films for members of Congress, NGOs and other decision makers.

Participant CEO Jim Berk reels off facts on the scope of the Participant community — 3.1 million individuals accessible via email; 777,000 “actions” (signing petitions, writing lawmakers, pledging behavioral changes) taken in a single recent month. Davis Guggenheim, maker of “An Inconvenient Truth” and the education-reform polemic “Waiting for Superman,” calls the company “the best place to build a social action campaign, and give a cause movie a really, really long life.”

But not every organization that joins a Participant campaign has been won over. One nonprofit operator, who declined to be identified, says the company was “more interested in their branding than anything, and it was a wasted opportunity to engage on an important issue.” A former member of the Participant social action team says: “They are really, really good at marketing.”

On the other hand, you can count producer Brian Grazer — who last summer attended the Skoll World Forum, where the billionaire celebrates social entrepreneurs — among the company’s most avid supporters. Grazer says no one should doubt Skoll’s commitment to fixing the world, describing it as “palpable and very moving.”

Industry insiders recall the Skoll who arrived in Hollywood as awkward and socially retiring. A Participant employee recounted one staff meeting: “Someone said, ‘Should we get started? Where’s Jeff?’ And he was already in the room.” At a crowded gathering, a friend says, Skoll would be the least likely to be picked out as the man with a net worth of $4 billion.

The former techie may have named charitable organizations for himself, but one-time aide Adams says he typically exhibits “an almost claustrophobic humility.” Skoll turns a question about himself from this reporter into an update on a “real hero,” Sakena Yacoobi — who defies Muslim extremists to fight for the rights of women and children in Afghanistan.

Not that Skoll is perpetually earnest. His employees say he’s a prankster who once spiked a companion’s food with flaming-hot habanero sauce and, on another occasion, called Participant’s chief operating officer from the Sundance Film Festival at 3 a.m. to treat him to a blast of grating techno music. Years later, Skoll still laughs at the memory.

The debilitating fever that beset him last September was just one in a series of life-changing events. In the prior year, 2013, he had been bedridden for months after back surgery needed to repair damage from an old snowboarding accident. Last October, a month after beating yellow fever, he married Stephanie Swedlove, a Canadian compatriot and creative manager at Pivot before she moved to Miramax TV. In January, he turned 50.

After it all, he moved with the urgency of a man making up for lost time. The future of Pivot TV — an enterprise intended to reach millennials and the politically active — became a particular preoccupation. The challenges from the outset: Do-gooder content can be a snooze (witness Al Gore’s Current), and corralling twentysomething cord-cutters has proven difficult (see Univision and ABC’s struggling Fusion channel).

In 2012, Participant had bought its way into more than 40 million homes by purchasing, then combining, Halogen TV and the Documentary Channel. Skoll felt his huge social action objectives mandated a position on television. Some of Pivot’s programs won acclaim, like “Welcome to Fairfax,” about young, street-savvy L.A. entrepreneurs; and “Fortitude,” a drama about the oddball denizens of a town in the Arctic. Pivot fortified its schedule with “Buffy the Vampire Slayer” and other millennial-friendly fare.

But several people who worked for the channel say privately in interviews that Participant CEO Berk shifted strategy frequently and fiddled with individual programs. They complain that his micromanagement particularly hobbled “TakePart Live,” the nightly public-affairs talker positioned as a network flagship. “There was endless tinkering, and it never had an opportunity to find its feet,” says one individual connected with the program, co-hosted by political scion Meghan McCain, before its December cancellation. Like many interviewed for this story, the individual declined to be named, in order to maintain relationships at Participant.

Insiders say that Pivot’s founding chief executive, Evan Shapiro, feuded with Berk about the channel’s offerings. Shapiro left last November, and soon afterward took a position as a digital exec at NBCUniversal. He declined to comment for this story.

Berk says some creative differences are to be expected when quickly ramping up a 24/7 television operation. He says Pivot deserves credit for expanding to 48 million households, and calls the operation (under new manager Kent Rees) “hell-bent” on reaching 60 million homes in 18 months. By the first quarter of 2016, Berk pledges, Pivot will sign up for a Nielsen rating.

Skoll’s decisions about what to do in TV will be influenced not only by the McKinsey review, but also by a talk he had while on a 2012 climate-change expedition to Antarctica. He recalls that fellow traveler Ted Turner advised him “to have multiple channels so that you can maximize your leverage with distribution.”

Skoll already has invested about $200 million in TV, according to two individuals familiar with Pivot. The owner says he is excited about the future, but signaled that change is likely, acknowledging, “The TV world we are operating in today is probably not sustainable. We are going to figure out what we are going to do.”

A strategic rethinking of Participant’s digital operations is also expected. Skoll called TakePart “interesting,” but wondered what has to happen “to step that up.” An initial thought: “It’s really the first time where it’s going to require more resources, more attention, and making the right strategic bets so that we don’t go down the wrong path.”

Unlike those of other entertainment powers, though, the Participant founder’s calculations will include novel and seemingly immeasurable variables. Which dollar helps the world more: the one spent on a renewable energy project in Africa, the one to fund Indian solar-panel evangelist Bunker Roy, or the one to back a Pivot show about climate change?

“My goal is to make the biggest difference possible in the world,” Skoll says. “I have only so many resources and so much time.”

His passion for repairing the planet requires Participant also rise to a whole new level. In his keynote address at the Toronto Film Festival in 2013, Skoll talked about going “10X” — expanding from 200-plus employees to more than 2,000 in a decade, and making 10 times as many movies, TV shows and stories for TakePart.com.

That goal spurred Skoll a year ago to hire two strategic planning executives who had previously worked for Disney. “It’s key for Participant, if we are going to be that important company 10 years from now, that we ramp up our strategic planning,” Skoll says.

Current and former employees note that they’ve seen a divide between Skoll and his chief executive, Berk, on some of the changes, particularly Skoll’s push for guidance from a yet-to-be named board of directors. Skoll says he views Berk as overloaded with day-to-day operations, a situation he understands from his time leading eBay.

“At some point, you just can’t take on much more,” says Skoll, explaining why a board and outside consultants would help Berk manage the company. “And I’m doing what I feel is my job, which is trying to figure out the long-term path for this organization.”

Berk’s detractors inside Participant, past and present, share their disdain for memos that he emails at all hours of the night and for what they say is his penchant for second-guessing others and even his own decisions. They say he has an obsession, large even by Hollywood standards, with where he sits at events (demanding, for instance, that he be at a premier table in the “pit” for the Golden Globes).

One former employee says he fussed obsessively with the color and fonts on the TakePart home page, and repeatedly rewrote the boilerplate about Participant’s mission, even when it seemed everyone had signed off.

Berk says that he has modeled his “empowering” style of management on Skoll’s. He did not respond to follow-up questions about critiques of his management style. Skoll, meanwhile, acknowledges that some employees find Berk’s “tight ship” style “challenging.” But he called that reaction typical, “especially when you are growing, and have a lot of moving parts.”

Skoll calls Berk “a great leader” and “my partner,” adding the two share an overarching goal — “to do what is best for the long term good of the company.”

The little boy who read books by the cartload and worried about what would become of the world is still not far from the surface in Skoll. “To keep up with him is exhausting, to watch him struggle is exhausting,” says Adams, the employee who was there at the beginning. “It’s also very exhilarating and inspiring.”

As he dashes around the world, meeting with heads of state and titans of industry, Skoll feels the press of time.

“It’s a real concern of mine every day,” he admits. “What can we do? How much can we do? How quickly can we address all these important things?”