The chosen year, 2045, is noteworthy. That is the year his foundation plans to end operations. It is also the year that Mr Gates will turn 90 and, by his own reckoning, his personal wealth is expected to touch $200 billion. This is a substantial sum. Since its inception, the foundation has spent over $100 billion, much of it on addressing the control of diseases such as malaria, polio, and AIDS, and on sanitation. Mr Gates’ role in the foundation and funding of the global network to make the Covid-19 vaccine accessible to developing nations offers the most recent example of impactful spending. In Africa, where the Gates Foundation has had a long association, the three priorities are to end maternal and infant mortality, ensure that the next generation is free from deadly infectious disease, and lift millions of people out of poverty. In and of themselves, these goals are unexceptionable and like the Buffet and Soros philanthropic ventures, the Gates Foundation has mastered the art of working constructively with local partners to drive his agenda. In India, for example, the foundation has worked closely with the governments of Bihar, Uttar Pradesh, and Andhra Pradesh on improving health and education outcomes.