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One side effect of speaking out, though, is that it has brought out more of the criticisms of the Gates Foundation's work that I've been hearing for years. The most thoughtful version goes like this: Bill Gates is an unelected billionaire--who is he to set the agenda on health or anything else? Two corollaries of that criticism are that the Gates Foundation has too much influence, and that I'm a technophile who thinks new inventions will solve all our problems. It's certainly true that I've never been elected to any public position, and I don't plan to seek one. And I agree that it's not good for society when rich people have undue influence out of the spotlight. But there's nothing secret about the Gates Foundation. We're open about what we fund and what the results have been. And we know that some of our critics don't speak up because they don't want to risk losing grants from us, which is one of the reasons we make extra effort to consult outside experts and seek out different viewpoints. (We expanded our board of trustees in 2022 for similar reasons.) We aim to improve the quality of the ideas that go into public policies and to steer funding toward those ideas that are likely to have the most impact. It would be even better if there were more funders in the areas we work in, but that isn't a reason for us to stay away from this work. I know this answer won't satisfy every critic, but it's the best one I can give. And yes, I am a technophile. Innovation is my hammer, and I try to use it on every nail I see. But innovation doesn't just have to be a new machine or vaccine, as important as those are. It can be a different way of doing things, a new policy, or a clever scheme for financing a public good. You'll read about some of these innovations in this book as well as the technological ones. And I'll also make the case for the unsexy work of strengthening public health systems, which-- when functioning well--can serve as the first line of defense against emerging diseases.