When you think of Bill Gates, you probably think of Microsoft. You also inevitably think of the world’s wealthiest person. But if this was all you knew of the tech giant, you’d be missing everything that has become Gates’ life after Microsoft – changing the world.

The Bill & Melinda Gates Foundation was founded nearly two decades ago with the lofty goal of making life worth living for all. No matter your sex, no matter your socioeconomic status, no matter the country you live in, you should have the opportunity to live a fulfilling life. To that end, ten years ago the foundation established the Grand Challenges in Global Health initiative. And ten years in, while there have been failures; some of those grand challenges are being met.

Bill and Melinda believe that the next 15 years will be transformational for global health, with their foundation playing a critical role in facilitating the changes. In the foundation’s annual letter, their “big bets” are suitably huge. The foundation sees child deaths around the world cut in half, women’s death in childbirth cut by two thirds, and polio finally being wiped off the face of the Earth. That’s for starters.

This seemingly cock-eyed optimism has better vision than you think. The Gates Foundation has already been heavily involved in making these big bets worth putting money on. Jay Wenger, former epidemiologist for the CDC and now director of the Gates Foundation’s polio eradication program, thinks that polio as a human disease is really at an end.

For example, in the last six months, there hasn’t been a single case of polio in the whole of Africa. That is fantastic news, and maybe isn’t shocking to us in the US who haven’t hosted the virus for decades. But the problem is that the world’s concerted polio eradication effort has been so successful that it’s hard to get anyone concerned about finally ending polio for good. This is especially true for poorer countries that still suffer polio like Afghanistan, and initiating the final blow is all the more difficult considering all the other socioeconomic problems these countries have.

“It’s very important that we finish this fight,” Wegner recently told Nerdist.

Another of the foundation’s big bets is that we will find the secret to destroying malaria, or at least its ability to destroy us. Again, some of the Grand Challenges have actually made progress here, from investing in scientific research to looking for better ways to store and transport vaccines. That involves taking a lot of risks that traditional marketplace competition just can’t afford.

“It’s not classic competition,” Bill Gates told Nerdist, “Everybody who works on malaria shares their ideas and it’s through the combination of better bed nets, better drugs, better delivery, better diagnostics, better modeling we need to defeat the disease.”

Countries might be able to identify a problem like malaria, but don’t have the science or the money to get a vaccine developed and into the population. That’s where philanthropy and foreign aid come in. That’s the foundation’s bet.

“You have to see what’s possible. You can eradicate diseases,” says Gates.

But giving the other big bets outlined in the Gates Foundation’s annual letter better odds will take global commitment and heavy investment. Increasing access to education, bolstering the agricultural infrastructure of Africa, forcing HIV to a “tipping point”– these 15-year goals need risk takers. Julie Sutherland, director of program-related investments at the foundation (a four-billion dollar annual budget), thinks that they are in a prime position.

“You have to have a really big appetite for failure, which Bill does.” Sutherland told Nerdist. “You’ve got to be willing to go out and accept the fact that a lot of these things aren’t going to work.” But the potential payoff is worth making the bet.

It won’t be just the Gates Foundation trying to destroy polio or help revolutionize mobile banking either. This year’s annual letter also announced a program called Global Citizen. By signing up with the program, “You will be able to get updates on how you can help, share what you’re learning, and connect with other people who care about similar issues. In the future, we hope it will become a portal that will help you find many organizations working on different global problems.”

It might be easy to think that with the resources available to the Gates Foundation, some of these bets should be pretty straightforward. But if Bill, Melinda, and their team have done anything well it’s acknowledging that you cannot just throw money at a problem and expect it to fix itself. You have to identify the root problems, whether they are scientific, political, or economic.

“At the end of the day, it’s not money that counts, it’s having a job, being well-educated, and having your kids be healthy.”

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Kyle Hill is the Science Editor at Nerdist Industries. Follow on Twitter @Sci_Phile.