The public health landscape today looks unquestionably different from how it did in the late 1990s when the Gates Foundation strode on to the ﬁeld. To its credit, the foundation has brought about a resurgence of interest in global health issues at a time when the cause was running low on energy and funds. Before Gates, global health funding covered little more than HIV and emerging infectious diseases – a bare shadow of the World Health Organization’s (WHO) Health for All vision of the 1970s. But Gates’ support for global health also raises questions: is it pushing us too much towards simple technological responses to multifaceted problems? With its inﬂuence so far-reaching, who will be willing and able to offer objective feedback?
The inﬂux of serious new money (as opposed to the stirring of existing donor pots that often takes place at international conferences) and attention from the Gates Foundation have revitalized the ﬁeld as a whole. Today, the foundation’s annual spending on global public health – about $1.8 billion – is larger than the WHO’s yearly budget. Donors have started thinking about global health as a broad and important discipline once again. With the launch of Gates’ Grand Challenges Initiative in 2003, some of the world’s best scientiﬁc minds turned their efforts to solving the problems of the world’s poorest.