Mark Suzman visits the Crop Science Center in Cambridge, United Kingdom, on March 30, 2022.
Mark Suzman visits the Crop Science Center in Cambridge, United Kingdom, on March 30, 2022. ©Gates Archive/Ed Thompson

Annual Report 2021


2021 was a study in contrasts.

It began with one of humanity’s great achievements – the rollout of safe, effective COVID-19 vaccines – but concluded with an unacceptable disappointment: On New Year’s Eve 2021, roughly 3 billion people, most of whom lived in low-income countries, were still waiting for their first shot.

2020 represented an inflection point for global health and development – one that came into sharper focus in 2021. After two decades of stunning progress, we faced undeniable setbacks. Malaria cases rose. Childhood vaccination rates fell. Tens of millions of people were thrown back into extreme poverty. The virus continued to spread in 2021, evolving into new variants that pushed local and national health systems to their limits.

Indeed, if 2021 provided a lesson, it was one that we’ve often been reminded of over the past two decades of the Bill & Melinda Gates Foundation: History doesn’t move in neat lines or follow preordained patterns. Progress isn’t inevitable. But it is possible, so long as people are willing to work together.

And around the world, that’s what happened. Despite once-in-a-century setbacks, you—our partners and grantees—made progress possible in 2021. Some fought the uphill battle against COVID-19 with heroism and selflessness. Others helped schoolchildren adapt to remote classrooms or put digital payment tools in women’s hands. Our African Union partners who discovered Beta and Omicron variants after building out their genomic sequencing networks. They warned the world.

In one of the hottest years in human history, we worked together to ensure more smallholder farmers have the tools to adapt to climate change. As U.S. college costs went up and enrollment went down, we helped launch a tool to help postsecondary institutions better understand if they’re providing economic mobility and opportunity to all their students. And at the 26th anniversary of the Beijing Women’s Conference, Melinda announced a historic $2.1 billion commitment to gender equality – which intersects all our priorities. I can’t wait to see how our partners use those funds to drive impact across women’s economic empowerment, women in leadership, family planning, and maternal health.

Despite a year of contradictions, I draw my optimism from the profound impact of our partners and the progress we will continue to build on.

As our foundation looks back on what was achieved in 2021 – and looks forward to the rest of 2022 and beyond – we continue to ask ourselves: How can we ensure our resources go as far as possible, as fast as possible?

How can we continue to play an additive, complementary role to the global network of institutions and individuals working on behalf of human progress?

How can we strengthen and diversify our partnerships, to sustain impact at the local level?

To that end, I am pleased to share with you the Bill & Melinda Gates Foundation’s 2021 Annual Report. This document is one of the ways our foundation holds itself accountable and ensures our contribution is complementary.

For the last decade, the foundation’s Annual Reports have outlined our direct grantee support – consisting of grants and direct charitable expenses – broken down by division and individual program strategies. This year, we have decided to include our foundation’s annual operational expenditures, as well. These include employee compensation and benefits, property and equipment costs, and other administrative funding associated with fulfilling our charitable mission.

Why did we make this change? These operational expenditures have regularly been included in the foundation’s annual financial statements, but we felt that including this figure alongside grants and direct charitable expenses provides a more accurate representation of the foundation’s overall annual charitable support.

We remain committed to being good stewards of the foundation’s resources – always looking to deepen our impact, which we measure in lives saved and opportunities provided for the poorest and most marginalized to achieve their full potential. Nothing could be more urgent – nor more powerful.

It is an honor to join forces in that endeavor with our outstanding friends, partners, and grantees around the world. To all of you, I extend my deepest thanks.

Mark Suzman
Chief Executive Officer
Bill & Melinda Gates Foundation

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Funding summary

In 2021, the foundation provided charitable support in the following areas:

Total charitable support


Program areas

Global Development $2,149,000,000
Global Health $1,757,000,000
United States Program $665,000.000
Global Growth & Opportunity $653,000,000
Global Policy & Advocacy $526,000,000
Gender Equality $90,000,000

Non-program areas

Other Charitable Programs $114,000,000
Operational Expenditure $717,000,000

Total direct grantee support


Global Development


Polio $695,000,000
Global Delivery Programs $561,000,000
Family Planning $267,000,000
Global Development Special Initiatives $181,000,000
Maternal, Newborn & Child Health $175,000,000
India Office $104,000,000
Africa Offices $79,000,000
Nutrition $56,000,000
Emergency Response $18,000,000
Multilateral Partnerships $13,000,000

Global Health


Malaria $276,000,000
Vaccine Development $230,000,000
HIV $220,000,000
Maternal, Newborn & Child Health Discovery & Tools $147,000,000
Innovative Technology Solutions $146,000,000
Discovery & Translational Sciences
Tuberculosis $138,000,000
Global Health Special Initiatives $107,000,000
Neglected Tropical Diseases $98,000,000
Pneumonia $98,000,000
Enteric and Diarrheal Diseases $86,000,000
Integrated Development $65,000,000
Innovative Introduction $6,000,000

United States Program


K-12 Education $329,000,000
Postsecondary Success $136,000,000
U.S. Economic Mobility & Opportunity $68,000,000
U.S. Charters $30,000,000
Pathways $29,000,000
Washington State $21,000,000
United States Program Data $18,000,000
Early Learning $14,000,000
Scholarships $13,000,000
United States Program Special Initiatives $7,000,000

Global Growth & Opportunity


Agricultural Development $398,000,000
Financial Services for the Poor $131,000,000
Water, Sanitation & Hygiene $94,000,000
Global Education $23,000,000
Global Growth & Opportunity Special Initiatives $7,000,000

Global Policy & Advocacy


Global Fund Core Contributions $248,000,000
Global Program Advocacy & Communications ** $76,000,000
U.S. Program Advocacy & Communications ** $48,000,000
Europe, Middle East, and East Asia Office $36,000,000
Philanthropic Partnerships $34,000,000
Development Policy & Finance $28,000,000
Tobacco Control $25,000,000
China Office $22,000,000
Global Policy & Advocacy Special Initiatives $9,000,000

Other Charitable Programs


Gender Equality


Gender Equality $90,000,000

* Financial figures are rounded to the nearest million and include grant payments, direct charitable contracts, and operational expenditures, but not program related investments (PRIs), for year ended December 31, 2021. Amounts in U.S. dollars.
** Amount does not include advocacy and policy spending to individual strategies.