A foundation funded by Microsoft Chair Bill Gates and his wife, Melinda, donated more than US$500 million as part of its global health program last year. The foundation, which has a US$24-billion endowment, also grants money in 3 other “program areas” — education, libraries and the Pacific northwest (where they live). Support for education alone totalled another US$413 million in 2002. The health funding included donations of US$200 million to the National Institutes of Health to support elimination of disease in the developing world. The global health program focuses on levelling the playing field between the world's haves and have-nots. The foundation notes that only 10% of health research spending is directed at diseases that cause 90% of the global health burden. “Our grant making is grounded in the belief that the death of a child in Africa is no less tragic than the death of a child in America,” the Gates state. — CMAJ