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 18.8 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.

Mothers participate in the Safe Motherhood Initiative, a program to safeguard women’s health following childbirth in Kasungu District, Malawi.

Healthy moms and babies

Mothers participate in the Safe Motherhood Initiative, a program to safeguard women’s health following childbirth in Kasungu District, Malawi.

We have the tools and resources to save the lives of moms and babies—reducing the number of preventable deaths during childbirth and in the hours and weeks after. But chronic underfunding and persistent gaps in the quality of care available to women threaten that future from becoming a reality. By expanding access to proven low-cost, high-impact innovations and trained midwives who can deliver quality care throughout a woman’s pregnancy, we can achieve a world where healthy moms give birth to healthy babies everywhere.

AI-enabled ultrasound

Two-thirds of pregnant women worldwide lack access to ultrasounds that can detect life-threatening conditions. New portable AI-powered ultrasound devices that connect to mobile phones are bringing this critical care to millions of women, especially those in underserved communities. With these innovative tools, health care workers are more equipped to identify potential risks and provide expectant mothers with important information about the health of their baby.

Learn more about AI ultrasounds

Intrapartum sensors

Monitoring vital signs during labor is crucial for health care workers to be able to act quickly on any complications, but traditional monitors are expensive and tether women with wires. Now, affordable, wearable, wireless sensors are changing the game by transmitting real-time data to a tablet, which empowers doctors and midwives in remote communities to make lifesaving decisions for mothers and babies.

Multiple micronutrient supplements

During pregnancy, women have increased nutritional needs as their bodies adapt to support their baby’s growth and their own health. High-quality prenatal vitamins, known as multiple micronutrient supplements (MMS), are now becoming available in many low- and middle-income countries. MMS contain 15 essential micronutrients proven to reduce low birthweight, anemia, infant mortality, and stillbirths.

Postpartum hemorrhage drape

Postpartum hemorrhage is the leading cause of maternal mortality worldwide. A calibrated obstetric drape at the edge of a bed makes measurement of blood loss fast and accurate, helping health workers gauge excessive bleeding at a glance. This groundbreaking, low-cost intervention enables swift treatment for women most in danger of life-threatening complications.

Learn more

IV iron infusion

Severe iron deficiency—or anemia—affects 37% of pregnant women worldwide, increasing their risk of complications like postpartum hemorrhage, preterm births, and delivering low birth weight babies. Instead of giving women iron tablets, which requires consistent use, providing a one-time, 15-minute iron infusion restores iron during pregnancy, preventing anemia and supporting healthier pregnancies.

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

Bimla Sahu, an ASHA (accredited social health activist) worker, weighs a child while Gayatri Ahirwar, an ANM (auxiliary nurse midwife), administers routine vaccinations in Bhopal, Madhya Pradesh, India.

Healthy children

Bimla Sahu, an ASHA (accredited social health activist) worker, weighs a child while Gayatri Ahirwar, an ANM (auxiliary nurse midwife), administers routine vaccinations in Bhopal, Madhya Pradesh, India. o Photo credit: ©Gates Archive/Mansi Midha

Malnutrition and preventable diseases remain major barriers to child health, but advancements in nutrition science and vaccine technology are offering transformative solutions. Over the past decade, the science of nutrition has experienced a renaissance, as exciting new innovations help tackle stubbornly high rates of malnutrition. At the same time, vaccine technology has been getting smarter, with next-generation vaccines protecting against multiple diseases and helping countries respond more effectively to disease outbreaks. These innovations are not just saving lives—they're helping children survive and thrive.

Infant probiotics

When added to breastmilk, B. infantis supplements have the potential to help at-risk infants gain weight and build a healthy gut microbiome—putting them on track to absorb the nutrients they need for long-term healthy growth and development.

Microbiome-directed ready-to-use therapeutic foods

Many children treated for wasting—the most severe form of malnutrition—end up relapsing. New formulations of ready-to-use therapeutic food (RUTF) provide the nutrients needed to treat severe wasting and help children regain weight, while also helping to restore the gut microbiome to prevent them from relapsing. This new type of treatment can also be more affordable and easier to source locally, because it’s made with common ingredients like chickpeas and bananas.

Maternal RSV vaccine

Maternal immunization against RSV—an illness that causes at least 100,000 infant deaths a year globally—can protect babies when they are too young to be vaccinated. In clinical trials, the vaccine was shown to be safe and effective in reducing the risk of severe RSV among infants under 6 months when administered to pregnant women.

Hexavalent vaccine

The hexavalent vaccine offers an efficient way to protect infants against six deadly diseases at once: diphtheria, tetanus, pertussis, Haemophilus influenzae B, hepatitis B, and polio. By reducing the number of injections, this combination vaccine will help streamline immunization efforts, making it easier for every child to get the protection they need.

Novel oral polio vaccine type 2 (nOPV2)

Thanks to efforts by the Global Polio Eradication Initiative to reach all children with polio vaccines, including nOPV2, more than 20 million people are walking today who would have otherwise been paralyzed by the poliovirus. nOPV2 is a next-generation polio vaccine that is being used to stop outbreaks of type 2 variant poliovirus—the most prevalent form of the virus—more sustainably.

Learn more about nOPV2

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 is making the HPV vaccine more accessible in lower-income countries by cutting delivery costs and simplifying delivery.

Learn more about HPV single-dose

Marou Haïnikoye (left) and Hamidou Hamadou (center) carry a cold box used to transport vaccines at the Dosso Health Centre. The vaccines are distributed to nearby communities in the Dosso region of Niger.

Healthy communities

Marou Haïnikoye (left) and Hamidou Hamadou (center) carry a cold box used to transport vaccines at the Dosso Health Centre. The vaccines are distributed to nearby communities in the Dosso region of Niger.

Communities in low- and middle-income countries often face barriers to accessing lifesaving products, but scientific innovation can help bridge these gaps with accessible, affordable solutions. New diagnostic tests, treatments, and vaccines promise to be cheaper and more effective, while advances in vaccine design are transforming products to better fit the needs of these regions and simplifying delivery for health care workers. Together, these groundbreaking innovations are helping lay the foundations for a healthier, happier future for all.

Vaccine microneedle array patches (VMAPs)

Microneedle patches deliver vaccines through the skin and do not require traditional needles, complex refrigeration systems, or highly trained health workers to administer them. These patches could eliminate the need for certain injections and help protect more people around the world from infectious diseases.

Dual-insecticide bed nets

The dual-insecticide bed net is an innovative prevention tool that combines two active ingredients to enhance protection against malaria, one of the leading causes of child mortality. Studies show it has reduced malaria cases by about 50% among children compared to standard nets, demonstrating its impact as a vital tool to help save lives and protect families.

Solar fridges

Innovative fridges use alternative energy sources and advanced cooling technology to preserve the viability of temperature-sensitive vaccines and medicines in areas with unreliable power grids. For example, solar direct-drive (SDD) refrigerators use solar power to keep vaccines at the proper temperature, helping ensure they reach clinics in rural and remote communities safely.

Drone delivery

Delivering vaccines and other health care supplies to remote areas that are inaccessible by roads can be extremely challenging. Drones can help bridge that gap. This technology is transforming health care delivery—ensuring consistent supply, preventing stockouts at clinics, and enabling rapid access to lifesaving vaccines and other supplies in isolated communities.

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, with Phase III trials already underway.

Learn more about tuberculosis vaccines

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.

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.

Learn more about monoclonal antibodies

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.

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.

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