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I like the positive tone particularly the paragraphs on malnutrition.
> We also are not as ready for the next pandemic as I hoped we would be by now.

He mentions the next 5 years will be crucial. There seems to be a very strong pipeline of initiatives by BARDA and numerous countries with significant investments as well going into it.

https://medicalcountermeasures.gov/nextgen/

I know HN will rip this to shreds because it's Gates and this is HN but I look forward to reading his annual letter each year. It's nice to read a optimistic take on the worlds direction once in a while, among the daily pessimistic domerism.