2023 Gates Foundation Annual Letter

Mark Suzman, Chief Executive Officer

Does our foundation have too much influence?

Here's how I see it.

During the COVID-19 pandemic, the remarkable, unprecedented progress made over the previous two decades in global health and development has stalled, and in many cases even reversed. Sadly, instead of accelerating efforts to fight infectious diseases, help reduce extreme poverty, advance gender equality, and address the effects of climate change, the world has so far failed to step up with the necessary political will and resources.

In that context, at the Bill & Melinda Gates Foundation we are proud to be doubling down on our commitment to our core mission: helping to ensure that every person has the chance to lead a healthy, productive life.

Last year, we created a new, expanded board of trustees, co-chaired by Bill and Melinda, to hold the foundation accountable and ensure that our decisions incorporate diverse, outside perspectives. On January 11, the board approved our 2023 budget of US$8.3 billion, an estimated increase of 15 percent over the 2022 forecasted payout – keeping us on track to meet our commitment of increasing our annual payout to US$9 billion by 2026.

This puts us in the privileged position of being able to give away more money than any other philanthropy. It also raises an important question we hear often: Does our spending, along with the doors that it opens, give us too much power and influence?

One line of critique is that our focus on certain problems and solutions draws attention and resources away from other important issues. Another is that we have disproportionate sway in setting national and global agendas, without any formal accountability to voters or international bodies.

These are fair questions – and we have an obligation to be clear about how we try to use our influence and why.

Since Bill and Melinda created the foundation 22 years ago, every choice we've made has been in service of our mission. Warren Buffett, who has generously contributed nearly half the foundation's total resources, has always urged us to "swing for the fences" and take big bets – all to benefit the health and welfare of people whose opportunities are limited because of where they happened to be born. (You can read Bill's Year Ahead 2023 for his take on some of those bets.)

It's true that between our dollars, voice, and convening power, we have access and influence that many others do not. It's also true that we are able to act in ways that others cannot. Because of this, we can call attention to and help find solutions for problems that otherwise might be neglected.

People listen to Bill and Melinda because of who they are, and to others at the foundation because of where we work. We try to use that privilege to elevate the voices of those who don't have a global platform and push relentlessly for world leaders to spend their funds to lift up vulnerable populations. We push, too, to ensure that innovations and solutions center the needs of women and girls, who are so often overlooked. Our staff use their access to learn from partners about what's needed in the field and to direct resources to make the impact we all want to see.

And because our foundation doesn't need to make a profit like corporations do or provide immediate results like governments do or raise funds like many NGOs do, we can make high-risk bets on novel solutions that may take a decade or more to pay off.

With this influence comes an enormous responsibility: to act where we can do the most good, play a role that's appropriate for a philanthropic organization, follow the evidence, be transparent, and work in partnership with those we aim to help.