The world has the tools and knowledge to dramatically improve health in developing countries and save millions of lives. Existing vaccines and drugs are effective against many deadly diseases, and recent progress in science and technology could revolutionize our ability to develop new tools to prevent and treat disease.

But advances in health too often fail to reach those who need them most—people in the poorest countries. Two-thirds of deaths in children under age five in developing countries stem from health problems that are preventable or treatable with existing tools.

Furthermore, research on diseases that primarily affect the developing world is severely neglected. Of the billions of dollars spent annually on medical research and development, only a small fraction is devoted to diseases such as tuberculosis and malaria. And only 20 of the 1,500 new drugs approved by the FDA over the past 25 years were for the diseases that disproportionately affect people in developing countries.

The Foundation’s Approach
The Bill & Melinda Gates Foundation is guided by the firm belief that all lives, no matter where they are lived, have equal value. Our global health mission is to help ensure that lifesaving advances in health are created and shared with those who need them most.

To date, the foundation has committed more than $6 billion in global health grants to organizations worldwide. Our grantmaking strategy focuses on two primary areas:

• Accelerating access: Funding to ensure that existing health interventions and technologies are made widely available in the developing world
  
  
• Supporting research: Funding for basic and clinical research to develop new vaccines, drugs, and other health tools to fight diseases that cause the greatest illness and death in developing countries

Malaria
One of the foundation’s top priorities is to fight malaria, a disease that kills 2,000 African children every day. Growing resistance to the most inexpensive and widely used malaria drugs in Africa has underscored the urgent need for malaria research. Foundation grantees are working to speed R&D on new prevention and treatment tools, and to expand access to existing malaria control tools, such as bed nets. Grant examples include:

• $258 million to the PATH Malaria Vaccine Initiative to develop a preventive malaria vaccine
  
  
• $35 million for the Malaria Control and Evaluation Partnership in Zambia, a model program to expand access to existing malaria control strategies
  
  
• $165 million for the Medicines for Malaria Venture to develop new drugs

HIV/AIDS
HIV/AIDS kills more than three million people every year, 99% of them in developing countries. The foundation is committed to fighting HIV/AIDS by expanding access to prevention and treatment and by supporting research on new prevention tools. The foundation is also an active member of the Global HIV Vaccine Enterprise, an alliance of funders and research groups formed to accelerate HIV vaccine research. Grant examples include:

• $200 million to establish Avahan, a national HIV prevention initiative in India
  
  
• $124 million for research on microbicides to prevent HIV transmission
  
  
• $50 million for the African Comprehensive HIV/AIDS Partnerships, a model HIV prevention and treatment program in Botswana

Tuberculosis
TB kills someone every 18 seconds, and is projected to cause 35 million deaths between 2000 and 2020. The foundation supports efforts to develop new TB drugs, vaccines, and diagnostic tools, and to strengthen TB control programs. Grant examples include:

• $82.9 million to the Aeras Global TB Vaccine Foundation for vaccine development
  
  
• $48 million to improve TB control strategies in communities with high rates of HIV/AIDS
  
  
• $23.3 million for the Foundation for Innovative New Diagnostics to develop low-cost methods for diagnosing TB

Nutrition
Poor nutrition contributes to about half of all deaths among young children in developing countries. The foundation provides grants to improve nutrition by accelerating development and production of foods fortified with essential nutrients, and developing staple crops with high micronutrient levels. Grant examples include:

• $50 million to the Global Alliance for Improved Nutrition to fortify foods with essential vitamins and minerals
  
  
• $25 million to the International Food Policy Research Institute to increase micronutrient levels in staple crops

Acute Diarrheal Illness
Severe diarrhea and diarrhea-related dehydration take the lives of up to three million children every year. The foundation supports efforts to improve understanding of the underlying causes of diarrhea and to develop new vaccines and treatments. Grant examples include:

• $40 million to the Institute for OneWorld Health to develop a new diarrhea treatment for children and infants
  
  
• $1 million for Johns Hopkins University to introduce zinc treatment for severe diarrhea among children in Africa

Immunization
Each year, tens of millions of children do not receive basic immunizations, and more than two million people die of vaccine-preventable diseases. Foundation grants for immunization include:

• $1.5 billion to the GAVI Alliance, a public-private partnership that helps developing countries purchase and deliver vaccines. GAVI has helped immunize tens of millions of children, saving more than 1.7 million lives since 2000.

Acute Lower Respiratory Infections
Severe pneumonia and other acute lower respiratory infections kill approximately two million children annually, many under age five. The foundation provides grants to improve understanding of the causes of lower respiratory infections and develop preventive tools. Grant examples include:

• $9 million to PATH to translate knowledge about the causes of pneumonia into an improved vaccine
  
  
• $3.6 million for the University of Maryland to introduce a vaccine for Hib pneumonia in West Africa

Reproductive and Maternal Health
More than 500,000 women die annually from complications of pregnancy and childbirth. In addition, millions of people in poor countries lack access to contraceptives and reproductive health information. The foundation provides grants to reduce pregnancy-related illness and death, increase access to contraceptives, and develop improved contraceptives. Grant examples include:

• $60 million for Johns Hopkins University to support reproductive health programs in developing countries
  
  
• $11.9 million to CONRAD to develop new, low-cost contraceptives

Newborn and Child Health
Children bear the greatest health burden in poor countries. Four million babies die each year before they are one month old, 99% of them in developing countries. Three out of four newborn deaths are preventable with low-cost tools such as antibiotics and clean childbirth kits. Grant examples include:

• $110 million for Save the Children to expand access to simple, low-cost tools to improve newborn health in developing countries
  
  
• $24.3 million to PATH for grassroots newborn health projects in India

Breakthrough Science
The foundation provides funding for research on scientific problems that, if solved, could lead to advances against multiple diseases. Grant examples include:

• $448 million for the Grand Challenges in Global Health initiative, which supports 44 innovative projects, such as research to stop insects from transmitting disease, and the development of vaccines that do not require refrigeration or needles

Other Infectious Diseases
The foundation supports efforts to develop and provide access to vaccines, drugs, and other tools to fight neglected diseases such as visceral leishmaniasis (“black fever”), schistosomiasis, and human papillomavirus. Grants include:

• $47.2 million for the Institute for OneWorld Health to complete development of a new low-cost treatment for visceral leishmaniasis

Advocacy
The foundation supports efforts to build awareness and understanding of global health challenges, develop novel ways to finance global health programs, and improve the collection and use of health data. Grant examples include:

• $3 million to the ONE Campaign and $2.3 million to DATA (Debt AIDS Trade Africa) to support advocacy on global AIDS, poverty, and debt relief
  
  
• $13.8 million to the Center for Global Development to conduct analyses of global health policy and financing issues to improve donor decision-making

Emergency Relief
Disasters, both natural and man-made, hit developing countries hardest. The foundation makes grants to leading relief organizations to respond quickly to disasters. Grants include:

• $3.5 million for five international relief organizations to provide emergency aid in areas affected by the 2004 earthquake and tsunami in Asia
  
  
• $5 million to several relief organizations to implement innovative programs to reduce famine deaths in Africa

Updated: March 2006