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.

One of my key goals as CEO of the Bill & Melinda Gates Foundation is improving how we work together. By that, I mean how we work as a team within the foundation and how we work with our larger team of partners to build better lives for the people we serve.

In the year since I wrote my last annual letter, I’ve made some important changes at the foundation—changes that will help all of us maximize the impact of our work together.