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.

As CEO of the Bill & Melinda Gates Foundation, my job is to make sure we are using our resources—our endowment, the expertise of our staff, and the voices of our leaders—to the utmost, so that we can have the maximum possible impact on people’s lives. And the next five years offer a historic opportunity to have an impact on the health and welfare of people in the developing world. Even in the face of very tough economic times across the globe, I am optimistic when I think about all that we can accomplish together with our partners.