Close-up of a pipette placing experimental vaccine into a microplate.

What will health care look like 20 years in the future?

Let’s look at some of the incredible innovations of the past 20 years and how they continue to save and improve lives around the world today.
Explore the past 20 years

2000

Gavi launches

Gavi, the Vaccine Alliance, launches to expand global access to vaccines for children in lower-income countries. Since 2000, Gavi and partners have helped immunize more than 1 billion children and prevent more than 17 million future deaths.

(R) Credit: Gavi

2002

The Global Fund

The Global Fund to Fight AIDS, Tuberculosis and Malaria launches and quickly becomes the world’s largest funder of programs to combat the three diseases.

Since its inception, the fund has invested more than US$60 billion, helping to save more than 59 million lives.

(R) Credit: The Global Fund

DNA Sequencing

2003

First human genome mapped

The Human Genome Project begins to revolutionize research into the diagnosis and treatment of many diseases.

(R) Video by Orhan Turan via Getty Images

A young woman is tested for HIV at the Naguru Teenage Health Centre in Kampala, Uganda.

2003

PEPFAR launches

U.S. President George W. Bush launches the United States President’s Emergency Plan for AIDS Relief (PEPFAR).

Since its inception, PEPFAR has helped save more than 25 million lives and enabled more than 5.5 million babies to be born HIV-free.

(R) A young woman is tested for HIV at the Naguru Teenage Health Centre in Kampala, Uganda. Photo by Per-Anders Pettersson via Getty Images

Odile Diekouehi administers the HPV vaccine to Aminata Outtara in Abidjan, Ivory Coast.

2006

HPV vaccine

The U.S. Food and Drug Administration (FDA) approves the world’s first vaccine against human papillomavirus (HPV). HPV vaccines are effective in preventing up to 90% of cervical cancer cases. Cervical cancer is the fourth most common cancer affecting women globally, with 90% of deaths occurring in low- and middle-income countries, where access to HPV vaccines, screening, and treatment remain limited.

In 2023, results from the KENya Single-dose HPV-vaccine Efficacy (KEN SHE) study are published, showing that a single dose of the HPV vaccine is as effective as a two- or three-dose regimen in preventing HPV infection.

(R) Odile Diekouehi administers the HPV vaccine to Aminata Outtara in Abidjan, Ivory Coast. ©Gates Archive/Ricci Shryock

2006

Rotavirus vaccination

Gavi adds vaccines against rotavirus, the most common cause of diarrheal deaths among children under age 5, to its programs.

In 2009, the World Health Organization (WHO) recommends rotavirus vaccines for all national vaccination programs, paving the way to greater access in low-income countries, where most rotavirus deaths occur.

(R) Close-up of a health worker's vest during the introduction of the rotavirus vaccine into a routine immunization schedule event in Abuja, Nigeria. ©Gates Archive/Nelson Owoicho

Access: Organizations develop an affordable vaccine

2009

Pneumococcal vaccine

Gavi launches an innovative financing mechanism to accelerate the global rollout of the pneumococcal conjugate vaccine (PCV), which helps protect against pneumonia, the leading infectious cause of death in children.

In 2019, WHO prequalifies a new PCV developed by Serum Institute of India and PATH, making this lifesaving vaccine more affordable for lower-income countries. 

(R) Workers at Serum Institute of India. Photo provided by PATH

Doctors at work in the laboratory where the new GeneXpert diagnostic system is installed at the Lala Ram Swawrup (LRS) Institute of Tuberculosis and Respiratory Diseases in New Delhi, India on 24th March 2011, World TB Day.

2010

First rapid molecular test for TB

The first rapid molecular test for the detection of tuberculosis (TB) is released after decades of reliance on sputum-smear microscopy. The new test helps diagnose TB more accurately and identify drug resistance earlier.

(R) Doctors at work in the laboratory where the new GeneXpert diagnostic system is installed at the Lala Ram Swawrup (LRS) Institute of Tuberculosis and Respiratory Diseases in New Delhi, India on World TB Day. ©Bill & Melinda Gates Foundation/Suzanne Lee

Bottles of antiretroviral drug Truvada.

2012

Truvada PrEP approved

Truvada, a combination therapy designed to provide preexposure prophylaxis for HIV-negative individuals at high risk of infection, is approved by the FDA, ushering in a new era in HIV prevention.

(R) Photo by Justin Sullivan via Getty Images

Feng Zhang, a scientist at the Broad Institute, explains how CRISPR works.

2015

CRISPR

A revolutionary technique for precisely editing DNA opens up entirely new approaches to improving health, from altering mosquitoes’ ability to transmit malaria to possible cures for human genetic diseases.

Watch to learn more about CRISPR

(R) Feng Zhang, a scientist at the Broad Institute, explains how CRISPR works. Video by STAT via Vimeo

CEPI

2017

CEPI launches

The Coalition for Epidemic Preparedness Innovations (CEPI) is launched to accelerate the development of vaccines against epidemic threats and expand access to lifesaving vaccines.

A woman holds onto her father while he receives his first dose of the Pfizer Vaccine at Central Westgate Mall on August 30, 2021 in Bangkok, Thailand.

2021

COVID-19 mRNA vaccines

In just 10 months, scientists develop safe and effective COVID-19 vaccines using mRNA technology. Decades of foundational research into mRNA allowed these vaccines to be produced quickly, and the technology is now being explored for the prevention of many other deadly diseases.

(R) A woman holds onto her father while he receives his first dose of the Pfizer Vaccine at Central Westgate Mall in Bangkok, Thailand. Photo by Lauren DeCicca / Stringer via Getty Images

A health worker prepares a malaria vaccination for a child at Yala Sub-County hospital, in Yala, Kenya, on October 7, 2021.

2021

WHO recommends first-ever malaria vaccine

The long-awaited malaria vaccine is a remarkable technical achievement that, alongside other tools, including bed nets, SMC, and indoor residual spraying, could save tens of thousands of young lives each year and inform the development of next-generation vaccines against malaria. The vaccine, called RTS,S/AS01, is also the first vaccine to combat a human parasite.

(R) Photo by Brian Ongoro via Getty Images

2021

HIV drug

FDA approval of cabotegravir, an injectable drug for HIV prevention, adds another option to a range of treatments that have reduced deaths from HIV/AIDS and related illnesses by 69% over 20 years, from 2 million in 2004 to 630,000 in 2022.

(R) A woman takes her antiretroviral drugs (ARVs) pills during the World Aids Day in Kibera. Photo by SOPA Images via Getty Images

Sam Nal uses a bed-net at her home in Phnom Dambang village, Pailin, Cambodia, on April 17, 2014. The village is under the Targeted Malaria Elimination (TME) Screening Program.

2023

Dual insecticide-treated bed nets

WHO recommends two new types of bed nets that are treated with two insecticides, to help countries overcome growing mosquito resistance to commonly used insecticides. Evidence from a trial in Tanzania shows that these nets nearly halve cases of malaria compared to pyrethroid-only bed nets. 

(R) Sam Nal uses a bed net at her home in Phnom Dambang village, Pailin, Cambodia. ©Bill & Melinda Gates Foundation/Prashant Panjiar

Explore the next 20 years

Discover the next generation of healthcare technology

New diagnostic tests, treatments, and vaccines in the research and development pipeline promise to be cheaper, more effective, and easier to deliver.

Imagine what’s possible in the next 20 years if the world keeps prioritizing health innovation for everyone.

Health innovations on the horizon

Click an innovation to learn more.

Monoclonal antibodies for infectious diseases 

Unlike a vaccine, which relies on the body’s ability to mount a strong immune response and requires time to develop a high level of protective antibodies, a monoclonal antibody can provide protection almost immediately after injection and can work even in people with compromised immune systems.

Monoclonal antibodies can be developed quickly and are extremely potent and generally safe. These medicines are the fastest-growing class of drugs and have been used to treat a range of illnesses and diseases, including cancer and autoimmune/inflammatory diseases. They have become better known in recent years as a treatment for mild to moderate COVID-19.

One of the most exciting prospects for monoclonal antibodies is for malaria prevention. In 2022, a National Institutes of Health (NIH) clinical trial found that a single dose of a certain monoclonal antibody was 88% effective in protecting adults in two rural communities in Mali during a six-month malaria season.

Learn more about monoclonal antibodies

Single-dose HPV vaccine

Ninety percent of cervical cancer deaths are in low- and middle-income countries. The HPV vaccine can prevent most cases, but getting it to girls in those countries can be challenging.

The HPV vaccine is an extremely effective way to prevent most cervical cancer cases. Girls in many wealthy countries have had access to the vaccine since 2006, but low- and middle-income nations have struggled for years to get access. However, a 2022 recommendation from WHO concluded that one dose of the HPV vaccine is as effective as a two or three-dose regimen. A single-dose schedule would make access to the HPV vaccine more equitable by cutting delivery costs and simplifying delivery.

Learn more about HPV single-dose

Lymph nodes tuberculosis pathological sample under microscope

Tuberculosis vaccines

The current TB vaccine is 100 years old, and its effectiveness is limited. New or improved vaccines are urgently needed to confront a major global health challenge.

The current TB vaccine, known as BCG, has been around for a century. It has been proven effective in infants, but researchers are exploring how changes in how the vaccine is used might boost its efficacy. The BCG ReVax clinical trial currently underway is an effort to understand whether revaccination with BCG can extend TB protection in adolescents. In addition, the M72/AS01E vaccine shows significant promise for preventing disease and is expected to enter Phase III trials in 2024.

Learn more about tuberculosis vaccines

(R) Video by jxfzsy via Getty Images

An ultrasound examination.

AI-enabled ultrasounds

Studies show that ultrasound devices aided by artificial intelligence (AI) can accurately identify high-risk pregnancies and estimate gestational age, which helps health care workers catch complications early and take action.

A critical step in preventing newborn deaths is early screening of pregnant women to identify those at risk of developing complications. In the United States, this is widely done through routine checkups and scans. But in low- and middle-income countries, access to diagnostic tools such as ultrasound machines and skilled medical technicians can be limited.

We support partners who are developing and testing portable ultrasound machines with diagnostic capabilities aided by AI. Studies show that these devices can accurately identify high-risk pregnancies and estimate gestational age, which helps health care workers catch complications early and take action. They are currently being tested in Kenya and South Africa to determine whether large-scale use can make a measurable difference in outcomes for mothers and babies.

Learn more about AI ultrasounds

(R) Video by Kristian Ozer Kettner via Artgrid

Next-generation diagnostic platforms

COVID-19 was a wakeup call, exposing the limitations of many current diagnostic platforms. Innovations in diagnostic testing, driven by the need to respond to COVID-19, could help provide essential tools in the fight against other diseases.

Diagnostic tools are critical to improving global health. Lessons learned and approaches developed during the COVID-19 pandemic are spurring innovation in the prevention and treatment of other diseases, such as the flu, TB, and HPV. Low-cost, point-of-care molecular testing platforms provide an accessible, sensitive, and portable option for health workers to get rapid, accurate results from patients in the remotest communities.

High-quality, accessible diagnostics are an important line of defense during public health emergencies and play an indispensable role in stopping the spread of disease.

Covid-19 mutation.
Video by nopparit via Getty Images

Next-generation contraceptives

Next-generation contraceptives such as a once-a-month pill, injectable contraceptives that last six months, and discreet microarray patches can empower women and girls to make contraceptive decisions that suit their life circumstances.

Contraceptive options have remained largely unchanged for generations, despite women’s changing needs. To address this inequity, our foundation has committed US$280 million annually from 2021 to 2030 to develop new and improved contraceptive technologies that respond to the preferences of women and girls in low- and middle-income countries and address the barriers that prevent them from using contraceptives, including cost and access. Next-generation contraceptives such as a once-a-month pill, injectable contraceptives that last six months, and discreet microarray patches can empower women and girls to make contraceptive decisions that suit their life circumstances.

Learn more about new contraceptive options

Health worker Abosede Animashaun counsels’ patients on family planning and contraceptives at the Jon-ken Hospital in Akoka, Yaba, Lagos State, Nigeria.
Health worker Abosede Animashaun counsels patients on family planning and contraceptives at the Jon-ken Hospital in Akoka, Yaba, Lagos State, Nigeria. ©Bill & Melinda Gates Foundation/Andrew Esiebo

mRNA vaccines for infectious diseases

During the COVID-19 pandemic, vaccines saved millions of lives, bringing the promise of mRNA technology into the spotlight. Now the world has an opportunity to apply recent innovations in vaccine technology to address major inequities in global health.

The use of mRNA COVID-19 vaccines during the pandemic proved how effective the technology could be in saving lives. Now researchers are exploring how to deliver on the promise of mRNA by bringing it to the fight against diseases that continue to kill people around the world, including HIV, TB, malaria, and the flu. With simpler research and manufacturing processes than for traditional vaccines, mRNA technology can help more countries and regions gain access to high-quality vaccines that meet the needs of their people.

Pharmacist holding the COVID-19 vaccine vials
Photo by franckreporter via Getty Images

Gut-informed nutrition 

Low-cost, ready-to-use microbiome-directed foods have the potential to help children gain weight and prevent malnutrition relapse. We fund research into the biology of nutrition and nutritional needs across the lifespan, especially for mothers and babies. This includes investigating specific bacterial strains and subspecies in the gut and developing targeted interventions that address inflammation and support better health outcomes. Functional foods such as garbanzo beans can also help improve gut and microbiome health as well as tackle malnutrition.

Learn more about garbanzo beans and gut health

A bowl of roasted chickpeas.
Photo by Portland Press Herald via Getty Images
A community health worker hold vials of the oral polio vaccination (nOPV2) during a door-to-door polio immunization campaign in the Hamar Jajab district, in Mogadishu, Somalia, on May 29, 2023.

nOPV2 for poliovirus

Greater availability and wider use of the next-generation polio vaccine, nOPV2, will mean that the goal of protecting all children from polio is within reach.

Almost 1 billion doses of the novel oral polio vaccine type 2 (nOPV2) have been administered globally since rollout began in 2021, protecting children against illness and paralysis. nOPV2 is as effective, safe, and easy to use as other oral polio vaccines and is much more genetically stable, making it a vital tool for helping to sustainably stop polio outbreaks. Plans are underway to increase production capacity dramatically over the next two years. Greater availability and wider use will mean that the goal of protecting all children from polio is within reach.

Learn more about nOPV2

(L) A community health worker hold vials of the oral polio vaccination (nOPV2) during a door-to-door polio immunization campaign in the Hamar Jajab district, in Mogadishu, Somalia. ©Gates Archive/Ismail Taxta

Alexandra and Fadila visit the Patte d'Oie Center in Ouagadougou, Burkina Faso on January 25, 2018.

New forms of HIV prevention

Injectables like CAB-LA have the potential to address some of the unique risks of HIV infection faced by young women and teen girls.

HIV is still a huge problem in many communities, especially in low- and middle-income countries, where millions of people cannot access antiretroviral therapy or preexposure prophylaxis (PrEP) to prevent HIV infection.

Injectables being researched, such as long-acting PrEP (CAB-LA) and lenacapavir, hold the potential to increase uptake through easier and less frequent administration.

Along with funding the development of new innovations like CAB-LA, we are committed to supporting a comprehensive strategy to ensure that long-term injectables to prevent HIV are available and affordable to everyone around the world.

(L) Alexandra and Fadila visit the Patte d'Oie Center in Ouagadougou, Burkina Faso. ©Gates Archive/Samuel Bollendorff

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