The world has made amazing progress in expanding access to health over the past few decades. Between 1990 and 2017, the number of people living in poverty has been cut in half, 6 million fewer children die every year, and 300 million more women in low-income countries have gained access to contraceptives.

But while progress is possible, it’s not inevitable, and further gains will rely on the commitment of traditional government donors, developing country governments, private-sector partners and philanthropists.

As you look to data and insights to maximize the social return on your giving, I want to share the thinking that drives the Bill & Melinda Gates Foundation’s investments in global health, talk about how we measure our impact and suggest opportunities that you might consider to partner with us.

Our Approach to Global Health Investment

The Gates Foundation’s approach to investing in global health is guided by two principles:

First, we believe that all lives have equal value, and second, we believe that everyone deserves the opportunity to lead a healthy and productive life.

We know that the foundation’s resources – while considerable – account for just a small portion of worldwide funding for global health and development. As such, we concentrate our investments where existing funds from other funders are insufficient, our support can have potentially catalytic impact, and we can assume risks that others cannot.

We feel a moral obligation to maximize the impact of every dollar entrusted to us, and we seek to do so by letting the best available evidence guide our decision-making. This means we invest in creating new tools and strategies that can close gaps in health equity between people living in wealthy countries and low- and middle-income countries. It also means that we concentrate on solutions to the leading causes of death and disability in low- and middle-income countries.

Finally, we invest in creating and delivering high-impact health products that haven’t been developed due to market failures. We work with governments, philanthropies, product development partners, and the private sector to fund the end-to-end development and delivery of effective diagnostics, drugs, and vaccines. Some examples include our work with:

Gavi, the Vaccine Alliance, which provides safe and effective vaccines that save the lives of between two and three million children under age five each year;

The Global Fund to Fight AIDS, Tuberculosis and Malaria, which has helped turn the tide on three of the world’s biggest epidemics, saving an estimated 22 million lives; and

FP2020, an initiative to provide 120 million women and girls with access to modern contraceptives and to dramatically reduce the number of unintended pregnancies and unsafe abortions occurring among women living in the world’s poorest communities.

How We Measure Impact

A central part of our business model is to make investments that drive toward measurable outcomes. We use the term “outcome investing” to describe this approach, and it means that we collaboratively reach agreement – up front – with our prospective partners about what success will look like for each investment.

We place emphasis on identifying the highest-level result possible and making that our goal. And in our results-based approach, we focus on the measurement and management of results, not activities.

This helps us drive toward clear and shared expectations, freeing up staff and grantees to do what they do best – collaborate to produce catalytic change and impact. Taking the time to specify and align on investment outcomes and the few, essential outputs required to produce them generates more effective measurement.

And a more sophisticated version of “outcome investing” involves tying grant payments to different targets, thereby creating incentives for grantees to outperform on satisfactory targets and earn additional payments.

Opportunities for Partnership

The world’s most challenging problems don’t come with ready-made solutions. Solving these types of problems requires optimism, resilience, and grit. It also requires partnerships and collaboration. Here are several ways that individuals can partner with the Gates Foundation.

Polio Eradication
The world is at the finish line for polio eradication, and we invite individuals to contribute to this by supporting the Global Polio Eradication Initiative’s (GPEI) goal of ending polio worldwide.

With more than $600 million in commitments from approximately 12 major donors, the Polio Eradication Fund is one of the world’s largest donor collaboratives and sets an example for how private donors, governments, and implementing partners can work together. With just 22 cases of wild polio virus reported worldwide in 2017, we have never been closer to the end. But vital funding gaps remain. In the final push toward eradication, new donors to the fund can play an essential role in wiping polio from the planet.

Family Planning
Another partnership opportunity is to invest in access to family planning, which brings together individual donors to collaborate and co-fund proven, catalytic programs that expand access to contraception. The fund utilizes private contributions that can be quick to address gaps that institutional and government funding often cannot. The fund also leverages the knowledge and expertise of the foundation’s Family Planning team and strategy to make catalytic investments where it matters most and provides donors the opportunity to channel support to vetted partners.

Health and Development Investments
Finally, our newest partnership opportunity is Gates Philanthropy Partners (GPP). GPP offers donors a way to maximize their impact by aligning their giving with the foundation’s health and development investments. We believe in the power of community and know that giving is a means to creating opportunity, optimism, better outcomes and bigger impact. We make it easy for GPP donors to join the fight against inequity and to improve the lives of the world’s poorest.


Original contribution by Chris Elias, President of the Global Development Program at the Gates Foundation