Bill & Melinda Gates Foundation announced its largest annual budget to date as it works toward the goal of a healthier, more prosperous world for all.
With global health budgets in decline overall, a portion of the additional funding will go toward advancing global health innovations that will save and improve the lives of some of the world’s most vulnerable people, including newborn babies and pregnant mothers living in low-income communities.
Its board of trustees formally approved the foundation’s $8.6 billion 2024 budget on January 13.
The budget, which represents an increase of 4% over last year and is a $2 billion increase over the 2021 budget, comes as global contributions to health in the lowest-income countries are stalling. While overall aid spending has leveled off, sub-Saharan African countries saw a nearly 8% decline in aid in 2022, even as they face growing needs and shrinking budgets due to debt and other financial pressures. The foundation has committed to increasing its annual spending to $9 billion by 2026.
“We can’t talk about the future of humanity without talking about the future of health,” said Bill Gates, co-chair of the Gates Foundation. “Every day, newborn babies and young children die simply because of where they were born. Mothers die giving birth, leaving families devastated. That keeps me up at night. It’s unacceptable, particularly because we have already developed many of the solutions that could save their lives. Building a stronger, more stable world starts with good health.”
Since its inception in 2000, the Gates Foundation has been focused on fighting the world’s greatest inequities, creating programs that address issues such as gender equality, agricultural development, and public education. A major focus for the foundation has been on reducing inequities in health by funding the development of new tools and strategies to reduce the burden of infectious diseases and the leading causes of child mortality in low-income countries. Thanks to strong commitments, the world has made tremendous progress in cutting child deaths from more than 9.3 million a year in 2000 to 4.6 million a year in 2022. Deaths from malaria and HIV were cut in half during the past two decades, and wild polio, which was paralyzing 350,000 children a year, has been reduced to only 12 cases in two countries.
“An investment in global health is an investment in our future. When the world puts money behind proven solutions, it builds stronger, healthier, and more resilient communities for generations to come,” said Melinda French Gates, co-chair of the Gates Foundation. “With low-income countries facing a whole host of challenges, now is the right time to recommit to saving lives and improving livelihoods.”
Despite the phenomenal progress, millions of children in poor countries still die before their fifth birthday of preventable or treatable diseases, and nearly 300,000 women die in childbirth while the tools exist to prevent their deaths. Ninety percent of the 340,000 women who die every year of cervical cancer live in low- and middle-income countries, even though there’s now a highly effective one-dose vaccine that can protect them against it.
At the foundation’s “The Future of Health” event at the World Economic Forum Annual Meeting, Bill Gates will showcase several health innovations that the foundation has funded and its partners have been developing that could save the lives of women and children. His talk will also address the role that artificial intelligence (AI) and other technologies can play in transforming health and improving lives for people living in low-income countries.
Gates will call on global leaders, philanthropists, CEOs, and others to help rebuild global trust and solidarity by joining together to save the most vulnerable people. The foundation predicts that if innovations currently in the R&D pipeline are properly funded, they could help cut maternal deaths by 40% in the lowest-income countries by the end of the decade, and further drive down preventable child deaths.
To emphasize that many solutions are simple, portable, and already close at hand, Gates and other foundation leaders will carry backpacks in Davos emblazoned with “The Future of Health” and filled with examples of products that could save millions of lives. They include:
A package of tools that can save 65,000 women by 2030 from dying of postpartum hemorrhage (PPH). PPH is the biggest cause of maternal death worldwide. The package includes a simple and inexpensive drape to better measure blood loss. When paired with interventions in a trial, these tools decreased cases of severe bleeding by 60%.
A one-dose HPV vaccine that helps protect against one of the most common cancers among women worldwide. Millions of girls in low- and middle-income countries haven’t received HPV vaccines, while most girls in high-income countries have. As much as 90% of cervical cancer deaths are in these countries. With a one-dose HPV vaccine, the barriers to vaccination are much lower, and efficacy remains high and lasting. Modeling estimates that more than 110 million cases of cervical cancer can be averted as the one-dose regimen is rolled out, in part through Gavi.
An AI-enabled ultrasound that uses AI algorithms to identify obstetric risk in pregnancy. This tool can save 390,000 infant lives by 2030 by helping health workers identify high-risk pregnancies in low-resource settings.
Vaccine microneedle array patches that can deliver vaccines through the skin without traditional needles, a complex cold chain, or a highly trained health worker to administer them. Early trials show these patches deliver the measles-rubella vaccine as safely and effectively as syringes and produce a similar immune response. This can help protect the hardest-to-reach children.
A stack of test strips that reduce production and shipping costs compared to existing cassette tests. These diagnostic test strips can be made in the billions and shipped inexpensively, allowing for faster response in the event of an outbreak. They can also increase the number of tests available for diagnosing malaria, of which two-thirds of cases go undiagnosed.
Multiple micronutrient supplements that restore a pregnant woman’s nutrient stores that she transfers to her baby. Studies show the supplements resulted in a reduced risk of low birth weight (12%) and a reduced risk of preterm birth (8%), and even better results among anemic and underweight women. These supplements, which are available now, could prevent 425,000 stillbirths.
“The Gates Foundation measures impact in terms of lives saved and opportunities provided to the poorest,” said Gates Foundation CEO Mark Suzman. “This new high-water mark for our budget will further our mission to help create a world where everyone has the opportunity to live a healthy, productive life.”
The incremental resources for 2024, both financial and human capital, seek to accelerate efforts for greatest impact across the foundation’s diverse priorities, ranging from polio eradication to scaling child azithromycin delivery in the world’s highest mortality settings to improving digital courseware in postsecondary education to accelerating the world’s TB drug portfolio.
Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. In developing countries, it focuses on improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty. In the United States, it seeks to ensure that all people—especially those with the fewest resources—have access to the opportunities they need to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Mark Suzman, under the direction of Co-chairs Bill Gates and Melinda French Gates and the board of trustees.