The next 25 years - Tachi Yamada, president of the global health programme at the Bill & Melinda Gates Foundation

Within 25 years, the world will achieve many major successes in tackling the diseases of the poor.

Certainly, we will be polio-free and probably will have been for more than a decade. The fight to eradicate polio represents one of the greatest achievements in global health to date. It has mobilised millions of volunteers, staged mass immunisation campaigns and helped to strengthen the health systems of low-income countries. Today, we have eliminated 99% of the polio in the world and eradication is well within reach.

Vaccines that prevent diseases such as measles and rotavirus, currently available in rich countries, will also become affordable and readily available in developing countries. Since it was founded 10 years ago, the Gavi Alliance, a global partnership that funds expanded immunisation in poor countries, has helped prevent more than 5 million deaths. It is easy to imagine that in 25 years this work will have been expanded to save millions more lives by making life-saving vaccines available all over the world.

I also expect to see major strides in new areas. A rapid point-of-care diagnostic test – coupled with a faster-acting treatment regimen – will so fundamentally change the way we treat tuberculosis that we can begin planning an elimination campaign.

We will eradicate malaria, I believe, to the point where there are no human cases reported globally in 2035. We will also have effective means for preventing Aids infection, including a vaccine. With the encouraging results of the RV144 Aids vaccine trial in Thailand, we now know that an Aids vaccine is possible. We must build on these and promising results on other means of preventing HIV infection to help rid the world of the threat of Aids.
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