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One of the most gratifying parts of my job as CEO of the Bill & Melinda Gates Foundation

is watching the successes we achieve year by year add up to our big 10- and 20-year goals. The ritual of putting together the annual report helps me reflect on how impact accumulates over time.

In 2005, for example, we wrote about the recent phase I trials for a new vaccine for meningitis, one of the most dreaded diseases in the world. In 2010, the vaccine was introduced in three countries in Africa’s Meningitis Belt. Over the next decade, we believe this vaccine will protect tens of millions of children from meningitis epidemics.

The Meningitis Vaccine Project reinforced an important lesson: Our grantees and partners are at the core of everything we do. We didn’t research and develop—or deliver—the new meningitis vaccine; that work was done by a vast public-private partnership, including an American governmental agency, a Dutch biotech company, and an Indian pharmaceutical manufacturer, not to mention dozens of African governments. We are effective only when we are working together with partners to achieve the objectives we share.