Mark Suzman, the CEO of the Bill & Melinda Foundation, with Talash Hujibers, the founder and CEO of InsectiPro, during their visit to the insect breeding facility in Limuru, Kenya, on April 27, 2023. InsectiPro breeds black soldier flies and crickets and aims to secure Africa's future by providing sustainable protein sources. The black soldier flies are used to produce animal feed and fertilizer, while the crickets are processed into high-protein food snacks for human consumption.
2024 Gates Foundation Annual Letter

Philanthropy’s once-in-a-generation opportunity

By Mark Suzman, Chief Executive Officer
Mark Suzman, CEO of the Bill & Melinda Foundation, with Talash Huijbers, founder and CEO of InsectiPro, during their visit to the insect breeding facility in Limuru, Kenya. ©Gates Archive/Brian Otieno
Big challenges & big potential

Big challenges & big potential

Anuja Bramhane, a postwoman, records the biometrics of a beneficiary at a camp set up by the India Post Payments Bank(IPPB) in Mumbai, Maharashtra.
©Gates Archive/Mansi Midha

In the years since the COVID-19 pandemic struck, we’ve witnessed the rise, after decades of decline, of extreme poverty. A resurgence of deadly infectious diseases. Climate disasters. Old wars and new ones.

It's hard to grapple with the inequities. Parents bury their children, lost to diseases people in rich countries will never have to worry about. Women die in childbirth who could have been saved with basic, low-cost interventions—simply because of their race, income, or where they happen to be born. Hundreds of millions of people live on less than $2.15 a day—on the same planet where, during the first 24 months of the pandemic, billionaires’ wealth rose more than it had in the 23 years prior.

And just as needs are mounting, low-income countries have fewer resources with which to meet them. Nearly half the world’s people now live in countries that spend more on servicing foreign debt than they do on health care. And official development assistance—the grants and low-cost financing that help the poorest countries meet basic human needs—has steadily fallen in real terms, as wealthy countries spend more on other priorities at home and abroad.

The good news is that there are solutions—existing and emerging—that will improve and save lives despite these challenges. Innovative digital tools can help more women access economic opportunity. New interventions involving the gut microbiome can help solve malnutrition. Agricultural innovations can help farmers increase production, even in the face of extreme weather.

But these solutions need support, or they’ll wind up merely as wasted potential. The sooner that support comes, the more people we can help today—and the better off we’ll leave the next generation.

This starts with governments, who play the biggest and most essential role in making sure that solutions reach the people who need them. But governments face competing priorities and very real fiscal constraints. Too often, financial support for emerging crises comes at the expense of funding for fundamental health and development challenges.

Governments need to do more. So do multilateral organizations and private companies, which play a vital role in driving innovation and progress. And there’s another sector that has so much potential to make the world a fairer, healthier place—which brings me back to Chuck Feeney.

Thousands of people are thriving today because he saw gaps and helped fill them. That’s what philanthropy can do—on a massive scale. Philanthropists all over the world are finding new ways to give to reduce inequities. I hope they’ll do more, and that more people step up to join them.

From ideas to impact

From ideas to impact

A mother waits for her children to receive the oral polio vaccine (nOPV2) at the Horseed internally displaced person (IDP) camp during a door-to-door polio immunization in the Kahda district, in Mogadishu, Somalia.
©Gates Archive/Ismail Taxta

The world is filled with innovators training their sights on big challenges. But going from an idea to an actual solution in people’s hands? That doesn’t happen often enough—and when it does, philanthropy has often played a bigger role than people may realize.

Consider this: Wild poliovirus once paralyzed 7,000 children a week. In 2023, that number was only 12 children—over the entire year. That progress was possible because of brilliant innovators who discovered breakthroughs and frontline heroes who made sure that solutions reached children, even in the most remote parts of the world. And so much of that was possible because of philanthropy: Rotary International, our foundation, and other organizations dedicated to a future where polio is a thing of the past.

This is just one example of how, in the last few decades, governments and nongovernmental organizations have made incredible advances in the fight against infectious diseases. Gavi, the Vaccine Alliance, has facilitated the immunization of more than 1 billion children. The Global Fund has saved 59 million lives from HIV, TB, and malaria. And the Carter Center and its partners are on the verge of making Guinea worm disease, a debilitating parasitic infection, the second human disease in history to be wiped off the face of the earth.

These accomplishments have a few things in common. They reflect the hard work of thousands of people. And they all were made possible by philanthropic contributions. Part of that is the money itself. But how philanthropists direct their funds, and who they collaborate with, is just as important.

For our foundation, that means looking for market failures—that is, areas where the public and private sectors may not have enough incentive to step in, so progress is unlikely if philanthropies don’t act. And it means catalyzing action from others, so that together, we can help scale lifesaving innovations and equip problem-solvers with the tools to go farther, faster.

This is one of the most exciting parts of philanthropy: it has the flexibility to adapt quickly and take risks others can’t, which can accelerate progress.

We move things forward, but we don’t do it alone. We do all our work in close collaboration with countries and communities to drive progress toward goals they’ve set—not the other way around. After all, while philanthropy can take risks and help fill gaps that would otherwise be overlooked or underfunded, it only makes a difference when it works in partnership with governments, the private sector, and local experts.

New client, Afolabi Tawakalitu, accesses mDoc’s website after signing up for services at the Balogun Market in Lagos, Nigeria, on September 14, 2023.
©Gates Archive/Nyancho NwaNri
Designing for equity: Philanthropy’s unique role

Designing for equity: Philanthropy’s unique role

Mukani Moyo, a post-doctoral scientist in food chemistry at the International Potato Center, extracts Vitamin C from an orange-fleshed sweet potato sample at the International Livestock Research Institute in Nairobi, Kenya.
©Gates Archive/Brian Otieno

Wherever I go, I’m asked what the Gates Foundation is doing about two major topics: climate change and artificial intelligence. Our foundation’s approach to these issues illustrates how we think about the role of philanthropy, and our role specifically.

First, climate change. The vast majority of climate spending goes toward mitigation efforts—that is, reducing carbon emissions. That’s critical for the future of our planet. But what about the effects that are already harming communities?

The fact is, the people who have done the least to contribute to this crisis—like smallholder farmers in sub-Saharan Africa—are already suffering its most severe consequences. Yet only about a tenth of global climate finance goes toward climate adaptation. And an even smaller fraction goes to interventions that would benefit the poorest.

So, working with governments and international groups like CGIAR, the world’s largest global agricultural research organization, the Gates Foundation funds the R&D and delivery of solutions that expand the options available to farmers. These innovations, like chickens that are better able to survive disease and drought-tolerant strains of cassava, may not always be profitable for private companies to produce. But they have the potential to help millions of families grow their incomes. That’s exactly the kind of market failure we look to address.

Then there’s AI. When any new technology emerges, there’s a good chance that wealthy countries will harness its power while low-income countries are left behind. The same is true for AI—it won’t benefit poor communities unless it’s designed to.

Recently, we put out a call for proposals for researchers exploring the use of artificial intelligence to advance equity in global health and development. Nearly 80% of the proposals we received, and all the grants we selected, were from researchers in low- and middle-income countries.

They plan to use large language models to improve medical record-keeping for young women in Pakistan, provide nonjudgmental HIV counseling in South Africa, produce personalized STEM lessons on video to Nigerian schoolchildren, broadcast information about malaria risks in local languages over Tanzanian radio—and so much more.

This work may still have happened without our involvement. But philanthropic support dramatically increases the likelihood that solutions will reach the people who need them, and soon.

Many ways to make the impossible possible

Many ways to make the impossible possible

Sarah Masenga, Communications Officer for Foundation for Civil Society, plants a tree for a GivingTuesday beach clean-up in Dar es Salaam, Tanzania. Photo by Foundation for Civil Society

We’re proud of the role our foundation plays to help solve urgent problems—but we’re far from the only ones doing this work. There are so many philanthropists bringing novel approaches and unique expertise to a wide range of issues.

The philanthropic ecosystem looks different than it did when I started doing this work over 15 years ago, and that’s a good thing. Donors around the world are bringing bold vision and lived experience to complex challenges. The African Philanthropy Forum helps African donors work together to drive inclusive, sustainable development across the continent. I’m excited by the work of foundations in India, China, and Singapore taking on local and global problems. As the next generation of philanthropists steps up, they’ll bring new ideas that raise the bar for what good giving looks like.

Of course, it’s not just the very wealthy who can make a difference. Small donations, taken together, make an enormous impact. Today, nearly half the world’s countries participate in GivingTuesday, a movement that has facilitated more than $13 billion in donations since its creation in 2012.

And then there are the millions of people around the world who send money from each paycheck back to their families in their home countries. This kind of giving, called remittances, reached $590 billion in 2020. That far surpassed all other sources of international aid combined.

You’d think that when people experience financial hardship, remittances would go down. But the opposite happens: People live with less so they can send more money home. During the COVID-19 pandemic, remittances went up—by 19%. 

There’s so much generosity in the world. And there are more resources than ever before to help philanthropists translate their generosity into impact, from donor collaboratives—also referred to as collaborative funds—to new models of large-scale giving.

Giving to the areas of greatest need

Whether donors have $10 or $10 million to give, they want to know their dollars are making an impact—and with so many options of where and how to give, the decision can feel daunting. Luckily, decades of innovation and collaboration within the global philanthropic sector mean that donors don't have to navigate the journey alone.

How can givers direct their dollars to the areas of greatest need—and trust that they’re being spent efficiently?

Treyvon Moliere (L) arbeitet während seines Praktikums mit einem Mentor zusammen. Das Praktikum wurde von YouthForce NOLA in New Orleans (Louisiana) vermittelt.
Treyvon Moliere (L) works at his internship with a mentor. The internship was placed through YouthForce NOLA in New Orleans, Louisiana. ©Gates Archive/Christiana Botic

In the United States, community foundations are an extraordinary resource. They have deep local ties and can help guide givers to the areas of greatest impact.

Donor collaboratives are a great resource for large-scale, international giving. These organizations bring givers together, provide deep expertise, and channel dollars to local organizations effectively.

Donor collaboratives and their common commitment to equity

Women share experiences of participating in gender trainings in Bihar, India.
Women share experiences of participating in gender trainings in Bihar, India. ©Gates Archive/Mansi Midha

Seventy percent of collaboratives report explicitly prioritizing gender or racial equity.

Some are issue-specific, like the END Fund, which is focused on eliminating neglected tropical diseases, or the Co-Impact Gender Fund, which supports women’s leadership. Others help specific communities. Anamaya focuses on the health and nutrition of tribal communities in India. Blue Meridian Partners looks to scale solutions that expand opportunity for people living in poverty in the United States and has raised $4.5 billion since its inception.

Are small organizations really equipped to absorb major gifts?

Habitat for Humanity of Greater Los Angeles has received $20 million of the $436 million donation from author and philanthropist MacKenzie Scott, one of the largest portions of the gift from the ex-wife of Amazon founder Jeff Bezos, officials announced this week."Among the projects that will benefit are the 10 new homes that are going up in Long Beach at the intersection of Pine Avenue and 14th Street, on Wednesday, March 23, 2022.
Habitat for Humanity of Greater Los Angeles received a $20 million donation from philanthropist MacKenzie Scott. Photo by MediaNews Group/Long Beach Press-Telegram via Getty Images

In 2020, MacKenzie Scott began giving large, unrestricted gifts to nonprofits and educational institutions, many of them small organizations. Some people questioned whether the grants were bigger than recipient organizations could handle.

But a study by the Center for Effective Philanthropy found that nonprofit leaders who received grants from Scott reported few negative consequences and were planning for the long term to minimize risks after the grants are spent. Today, those grants are strengthening nearly 2,000 effective institutions worldwide.

I know there are people genuinely committed to philanthropy with limited capacity to give today. But for those who can, starting now has enormous benefits.

For one thing, you’ll actually get to see the impact you make. You’ll also have time to build trust and understanding with the people doing the work. Strong partnerships are their own reward—but they also lead to greater impact. And the sooner you start, the more momentum you can build. That’s especially important when you’re working on issues where progress is measured not in months, or even years, but decades.

The nonprofit, Tuesdays for Trash, hosts a trash pickup for GivingTuesday in 2022. Photo by Tuesdays for Trash

What billions of dollars could do

What billions of dollars could do

Research scientist, Ochieng Ouko from the Kenya Agricultural and Livestock Research Organization (KALRO) holds baby chicks at the poultry research unit in Naivasha, Kenya.
©Gates Archive/Brian Otieno

There’s so much that was remarkable about Chuck Feeney’s giving, but one thing that sticks out to me is how he prioritized people furthest from opportunity.

Most rich donors express a desire to give to social change—but in practice, a greater proportion of their giving goes to elite universities and cultural institutions. Feeney did both. He gave nearly a billion to his alma mater, but he also gave billions to basic human needs.

Imagine the possibilities if more donors followed his lead. What if, alongside a $100 million dollar gift to a highly selective university, they also gave $100 million to set up a system that makes online textbooks free for every college student in the United States, forever? If a donor gave $20 million to an institution searching for a cure for cancer, and $20 million to fund research on malaria, a disease that still kills a child every minute? Or $5 million to their child’s private school and $5 million to support quality teaching across sub-Saharan Africa?

I know that very few people are willing or able to give away all their wealth. But there’s a lot of ground between Feeney’s blockbuster generosity and the current state of giving among the ultra-wealthy—and so many opportunities to make an impact.

Globally, the net worth of the world’s 2,640 billionaires is at least $12.2 trillion. With $1 billion, philanthropists could fund a set of high-impact, low-cost interventions that could save the lives of two million additional mothers and babies by 2030. With $4 billion, they could help a half-billion smallholder farmers become more climate resilient and reduce greenhouse gas emissions from agriculture by 1 gigaton a year by 2030. With just over $7 billion, they could get vaccines to 300 million people, preventing at least 7 million deaths.

If every billionaire on earth donated 0.5% of their wealth, it would unlock $61 billion dollars—enough to cover all the above and still have $49 billion left over.

That kind of money could create so many opportunities for so many people—but only if it gets spent, and spent well. In the United States, Canada, and Australia, philanthropic foundations are required to disburse at least 5% of their assets each year. I personally believe this could be higher—especially given that we’re talking about tax-advantaged dollars. Though it’s better than the current situation across most of Europe, where foundations face no payout requirements at all.

Midwife Eva Nangalo gives a swaddle demonstration to first time mother Shakira Nankya, 23, at the Nakaseke General Hospital in Nakaseke District, Uganda.
©Gates Archive/Zahara Abdul

Today’s world has no shortage of complex problems to be tackled, or innovators ready to take them on. Around the world, they’re on the cusp of breakthroughs that can save and improve millions of lives. Some of these discoveries are already reaching people in need. Others will take some time but have the potential to change life as we know it. But without generous investment and persistent support, great ideas remain just that: ideas.

If more people step up their commitments and focus their resources on the areas of greatest need, those ideas can translate to impact. That means more farmers who can support their families no matter the weather, more children who don’t suffer from preventable diseases, and more mothers for whom childbirth is a source of joy, not fear.

Together, we can realize the full potential of philanthropy at the very moment the world needs it most.

Mark Suzman
Chief Executive Officer
Bill & Melinda Gates Foundation

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