How do you spend $5 billion a year?

Sue Desmond-Hellmann
Bill & Melinda Gates Foundation
3 min readJan 25, 2017

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One question that I’m asked almost everywhere I go is how the foundation decides to invest the money that Bill, Melinda, and Warren Buffett have entrusted to us. There are so many urgent causes that need attention around the world right now, with new crises seemingly springing up every day. Even with our significant resources we can’t do everything. Instead, the foundation focuses on areas where we believe we can make the greatest impact.

To do that, we have to know at least two things. First, what needs fixing? As a scientist and a physician, I know that you can’t fix what you can’t define. Second, we need to know what progress we are making so we can be sure we are on the right track. This information helps the foundation and our partners to set goals, and hold ourselves accountable along the way to achieving them. And the more we know about each challenge — and what it will take to meet it — the more likely we are to reach our ultimate vision of a world where every person has the chance to lead a healthy, productive life.

This is where the power of data comes in.

In fact, robust and rigorous data are essential in helping us turn the tide on many of the deadly and debilitating diseases that kill millions of people, and trap millions more in poor health and poverty.

Fortunately, there is a world class institution right on the foundation’s doorstep in Seattle that is an invaluable source of data and evidence on global health trends: The Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

You’ve maybe never heard of the IHME but it has been a game-changer in global health. Before the IHME began its work a decade ago, data on global health trends were typically inconsistent and thus not especially reliable. That’s not much use to people trying to develop policies to fight diseases or make decisions on where to invest scarce resources.

IHME data visualization of 2015 global burden of disease

Thanks to the IHME, we now have standardized health metrics across a range of different diseases for countries broken down by age, sex, and population. And this meticulous analysis allows policymakers and public health practitioners to identify ways to better fight a range of diseases. In my book, that makes the IHME’s work a true global good.

Our foundation is among many organizations that have benefited hugely from the IHME’s insights as we decide where we can have the greatest impact, and we are committed to helping the institution expand its programs. So today we are announcing a $279 million grant to the IHME.

This 10-year investment means the IHME can not only build on its current efforts, which include evaluating progress on the Sustainable Development Goals and tracking how health resources are spent throughout the world, but also develop innovations that forecast future health scenarios to allow decision-makers to plan more purposefully.

As one of the largest donations in the foundation’s history, this contribution is a vote of confidence in IHME’s work. It is also a testament to our belief in the University of Washington as one of the world’s foremost public research universities, which continually pushes the boundaries of research and innovation.

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