2022 Gates Foundation Annual Letter

Mark Suzman

We begin 2022 at a pivotal moment for the Bill & Melinda Gates Foundation and the world. The COVID pandemic has been both a profound shock and a clarion call to action to support the countries and communities that have been hardest hit.

In addition to its direct impact measured in millions of lives lost, the pandemic has slowed, halted, and even reversed hard-won gains in global health and development. After nearly two decades of unprecedented progress, we have seen tens of millions of people thrown back into poverty, childhood vaccination rates drop, and diseases from malaria to tuberculosis resurge. All of this has been exacerbated by climate change, which has been especially hard for the rural poor who depend on agriculture for food and income. And in the United States, we've seen massive setbacks in education due to the pandemic, with the impact falling hardest on Black, Latino, and low-income students.

Meanwhile, income and wealth inequalities continue to grow, and this has contributed to increased scrutiny of the very wealthy and skepticism about the motives and role of philanthropy.

At a time of such profound challenges, we must ask ourselves: What is the role and value of a foundation like ours relative to governments, the private sector, and civil society around the world? How should we be measured and evaluated? How can we better hold ourselves accountable and make sure our contribution is additive and complementary to that of others?

Today marks an important milestone in how we answer that last question. We are proud to announce the appointment of a new board of trustees – which includes members from outside the Gates and Buffett families – to provide additional input, strategic guidance, and fiduciary oversight to the foundation. In part, this is a response to the sad death in late 2020 of Bill Gates Sr., Bill's father, an honorary co-chair, and a long-time guiding voice at the foundation, as well as the decision by Warren Buffett last year to step down after nearly 15 years of service as a Trustee. But it also represents an explicit recognition by Bill and Melinda, especially in the wake of their divorce, that the foundation will be well served by the addition of strong, independent voices to help shape our governance. They will bring diverse perspectives and expertise that will help to ensure the future stability and impact of the foundation.

We are honored that as an initial step three deeply knowledgeable and respected individuals have agreed to join us. Between them, Strive Masiyiwa, Minouche Shafik, and Tom Tierney bring an incredible track record of impact across global business, philanthropy, and development, and we couldn't be more excited to have them join the board. I have had the privilege of working with each of them in different capacities over the years and know they will bring integrity and insight to our shared mission of creating a world where every person has the chance to live a healthy, productive life. Bill and Melinda have also asked me to become a board member in my role as foundation CEO. The board could include up to nine total members, and we're in active conversations about adding to our initial slate to enhance representation across gender, geography, and expertise.

A global vision

I arrived in Seattle 15 years ago this month to lead policy and advocacy for a new division at the foundation focused on global development, which was launched after Warren Buffett's unprecedented financial commitment to the foundation. At that time, the foundation was expanding its existing work in global health and U.S. education into new areas, including agricultural development; financial services for the poor; and water, sanitation, and hygiene.

I was coming from seven years at the United Nations, where I helped launch the Millennium Development Goals (MDGs) under the leadership of then Secretary-General Kofi Annan. Those goals, adopted in 2000 by every country in the world, set out an ambitious agenda for humanity centered on measurable targets for poverty eradication, health, and education. They and their successors, the Sustainable Development Goals, represent the world's collective commitment to a better life for all its people.

The goals were very personal to me – and they were the main reason that I decided to leave my job as a journalist at the Financial Times and take my career in a new direction.

I grew up in apartheid South Africa, part of a politically prominent family who fought the legislated crime perpetrated on people of color while also benefiting from the comfortable lifestyle and opportunities offered to us as a white family and to me as a white male. Even as a child, I understood that fundamental unfairness, and it left me with a deep desire to use the advantages I had been given to help tackle injustice and inequality. A career in journalism was my initial entry-point, and that included covering the historic demise of apartheid and the election of Nelson Mandela as president of a democratic South Africa.

The Bill & Melinda Gates Foundation was founded the same year as the MDGs were launched and was born from a similar impulse. In the late 1990s, Bill and Melinda learned that millions of children in lower-income countries were dying of preventable diseases like rotavirus that had essentially been eliminated in wealthier countries. Their background in technology had fostered a faith in the power of innovation to provide opportunities for those who had been left behind, and they were eager to try to overcome the barriers that prevented vaccines and treatments from getting to the poorest. At the same time, conscious of the enormous benefits they had received from their own educational opportunities, they launched an ambitious set of investments to try to improve public education in the United States, focused particularly on providing more opportunities for Black, Latino, and low-income students to graduate from high school and pursue a college education as a pathway to a better life.

The foundation's vision of building new partnerships across the private and public sectors to leverage innovation for the poor bore early fruit. For example, we joined a range of governments and other partners in the early 2000s to form Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria—two groundbreaking initiatives that have saved about 60 million lives.

But these were too often the exceptions. In practice we tended to focus disproportionately on a small set of partners primarily located in the United States and Western Europe and saw little need to engage directly with governments or connect our work to wider agendas like the MDGs.

We often let our enthusiasm about a potential breakthrough innovation blind us to the reality of the complex set of relationships needed to achieve and sustain implementation and impact, including the vital role of government and community engagement at every level. Even with our work in the United States, we quickly ran into setbacks after our first major education effort to build smaller schools did not show the results initial pilots had promised.

In the words of Gra?a Machel, a long-time champion of health and development in Africa and a foundation partner, we needed to get much better at "listening with respect" to other points of view in the countries and communities where our work was focused.