A Roadmap to a Healthier Future

According to modeling done by the Gates Foundation and the Institute for Health Metrics and Evaluation at the University of Washington, the world can save millions more children’s lives and make some of the deadliest childhood diseases history by 2045 by:

• Investing in Strong Primary Health Care Systems
  • According to the World Health Organization (WHO), a robust primary care system can meet 90% of a person’s health needs throughout their life.
  • For less than $100 per person per year, a robust primary health care system can prevent up to 90 percent of child deaths.
• Deploying Proven Tools and Breakthrough Innovations
  • A suite of proven malaria interventions can accelerate eradication of the disease:
    • Dual-insecticide bed nets (or dual-AI bed nets), treated with two different insecticides to kill or disable mosquitoes, are estimated by the New Nets Project to have prevented 13 million cases of malaria and saved nearly 25,000 lives across sub-Saharan Africa between 2019 and 2022. And a study in Tanzania published in The Lancet demonstrated that Interceptor G2 nets cut malaria infections in children by nearly half.
    • Gene drive for malaria control is part of a growing field of genetically based vector control which uses genetic tools to reduce populations of disease-carrying insects like mosquitoes. Gene drive can ensure that helpful mosquito traits disrupt malaria transmission and spread quickly through future generations. In the most remote, high-burden areas where malaria persists, gene drive can offer cost-effective protection that doesn’t depend on traditional delivery methods or human behavior change like bed nets and medications. According to a 2024 study published in Nature, gene drive technology was shown to achieve 71.6-98.4% reductions in malaria vector populations across diverse African settings with just a single release.
    • Spatial repellents, recommended by WHO, are new, paper-like devices that release chemicals to repel or kill mosquitoes—offering a critical prevention option especially in hard-to-reach areas. A study in Kenya and published in The Lancet found them to reduce the rate of new malaria infections by more than 30%, even in a high-transmission area
    • mRNA vaccine and combination vaccines are in early trials, and a long-acting injectable chemoprevention candidate is in the first phase of human studies.
    • Genomic surveillance and mapping tools like those of the Malaria Atlas Project track transmission, resistance, and impact, allowing more targeted deployment of resources.
    • Artificial intelligence (AI) to leverage smarter, faster and cheaper delivery of safe, cost-effective medicines to dramatically improve lives.
  • Incredible advancements in HIV prevention and treatment options, with more to come on the horizon, can drive AIDS deaths to single digits. New long-acting methods are emerging that could offer protection over weeks or months with a single dose, rather than requiring daily pills:
    • Lenacapavir for PrEP: A twice-yearly injectable showing near-complete protection in clinical trials. The drug, developed by Gilead, was U.S. FDA approved in June 2025. Scaling up access to lenacapavir to just 4% of the population in high-burden countries could prevent up to 20% of new infections.
      • Gilead and the Global Fund finalized an agreement in July 2025 to provide access to lenacapavir for up to two million people, with the aim of rolling it out in at least one lower-middle income country by the end of 2025.
      • Annual formulations are currently in development and could be available by 2028.
      • On Wednesday, Sept 24, the Gates Foundation, alongside other partners, expects to announce a new investment to complement efforts in making this breakthrough tool more accessible for people living in high burden countries – and help accelerate the end of HIV.
    • MK-8527: A once-monthly oral HIV prevention pill in development by Merck is now moving into Phase 3 trials.
  • A new maternal vaccine for Respiratory Syncytial Virus (RSV) and a maternal vaccine in development for Group B Streptococcus (GBS) can protect babies from deadly respiratory illness, one of the biggest killers of children where access to healthcare is often limited.
    • RSV is the most common cause of acute lower respiratory infection and pneumonia in young infants, which are most dangerous in the first few months of life. While RSV infections are not passed from mother to baby in the womb or during childbirth, RSV antibodies transferred during pregnancy can help protect infants from respiratory tract infections in the early months of life.
      • The maternal RSV vaccine has now been recommended by WHO, and a maternal RSV vaccine program is approved by Gavi’s Board as part of Gavi 6.0.
    • GBS is a bacterial infection that, according to WHO, can be transmitted during pregnancy, birth, or in the early weeks of life, and can cause serious illness in pregnant women and their babies. In pregnant women, it can lead to maternal sepsis, while transmission to baby can cause stillbirth, neonatal sepsis, pneumonia, meningitis or hinder neurodevelopment in infants.
      • A study in The Lancet showed that GBS is estimated to cause at least 90,000 newborn deaths and 46,000 stillbirths annually – with over half in sub-Saharan Africa.
      • A GBS maternal vaccine is in development and undergoing clinical trials.
• Prioritizing children’s health by funding programs like Global Fund and Gavi, which have saved 85 million lives since 2000
  • The Global Fund is one of the most effective initiatives the world has invested in over the past two decades. It has saved more than 70 million lives and reduced deaths from malaria, AIDS and TB by more than 60% since 2002. Every $1 invested in the Global Fund yields $19 in health and economic returns. The 2026-2028 fundraising cycle will be the eighth Global Fund replenishment cycle.
  • Gavi, the Vaccine Alliance, has protected an entire generation—over 1 billion children—against infectious diseases since 2000. This includes reductions in child mortality across 78 lower-income countries, according to WHO. Gavi also plays a key role in improving global health security by supporting health systems, as well as funding global stockpiles for Ebola, cholera, meningococcal and yellow fever vaccines.
  • In a time of shrinking health aid, the Global Fund and Gavi are evolving to improve how they work with country leadership to deliver life-saving impact. This includes focusing on sustainability and helping countries transition to self-reliance.