More than two decades ago, when Bill Gates and Melinda French Gates were both working at Microsoft, they came across a newspaper article about a highly contagious diarrhea-causing virus called rotavirus that was responsible for the deaths of hundreds of thousands of children each year in low-income countries. They wondered: How could they have not known about this devastating disease?

In higher-income countries, rotavirus is easily treated, and a vaccine is available. Stirred by this gross inequity in access to health care, Bill and Melinda resolved to devote themselves to addressing such issues, leading them to establish their foundation.

The foundation began working in India in 2003 with the launch of Avahan, an HIV prevention program that is estimated to have prevented 600,000 new infections. We also joined with other partners to support the Indian government in eliminating polio. This coordinated effort, which involved mobilizing 2.3 million volunteer vaccinators to reach 170 million children with repeated doses of oral polio vaccine, led to India being declared polio-free in 2014.

Our efforts in India focus on key issues that will affect the future of India’s most vulnerable communities: reproductive, maternal, newborn, and child health and nutrition; sanitation; agricultural development; gender equality, and digital financial inclusion. We have invested more in India than in any other country besides the United States.

In collaboration with India’s central and state governments and with a particular focus on Bihar and Uttar Pradesh, we work to develop innovative solutions that improve the quality and coverage of key services. Our data-driven approach allows us to determine what works and what doesn’t and to adjust our strategy and approach accordingly.

A health assistant gives polio drops to a child during a house-to-house campaign

We have a Memorandum of Cooperation (MoC) with India's Ministry of Health and Family Welfare under which we provide technical, management, and program design support for key health initiatives. Under the MoC, the foundation supports the ministry's work to improve health outcomes, such as by reducing maternal and child mortality, improving nutrition services, and increasing immunization coverage. Collaborative efforts are being made to increase access to family planning measures among younger women and reduce the burden of specific infectious diseases, such as tuberculosis, visceral leishmaniasis, and lymphatic filariasis. The foundation also supports the government’s efforts to strengthen supply chains as well as the management of human resources for health.