Future Perfect 25 — 2025: 25 Changemakers Keeping Global Health Progress Alive

When the Future Perfect project launched in 2018, it set out to report on the most important issues the world is not paying enough attention to. For 2025, that mandate points squarely to one urgent story: a global squeeze on foreign aid and development funding that puts decades of health and development gains at risk.

Global aid is falling even as need rises. In the United States, recent cuts and institutional erosion have intensified the strain. Those shortfalls show up in rationed food aid, clinics operating on skeletal hours, and fractured supply chains that slow life-saving treatments.

Routine childhood immunization—the single best bargain in public health—has plateaued, leaving more than 14 million "zero-dose" children completely unprotected. Malaria paints an even darker picture: an estimated 263 million cases and 597,000 deaths in 2023, overwhelmingly in Africa and disproportionately among young children. Conflict, climate shocks, and funding gaps are blunting the impact of new tools. Even polio, once nearing eradication, faces backsliding as its global campaign confronts a proposed 30 percent budget cut in 2026 and projected shortfalls through 2029.

Faced with these trends, defeatism is understandable—but unnecessary. We may not be able to restore past funding levels, but we can double down on what works: cheaper, smarter technologies; stronger delivery systems; persistent local implementation; and better decision-making about trade-offs.

Our selection: 25 people making the most difference

For the 2025 Future Perfect 25, we chose 25 changemakers who are sustaining progress across four essential domains:

Innovators who bend the cost curve

When budgets shrink, engineering and better design must pick up the slack. This group includes people building AI-assisted drug-discovery pipelines that shorten development timelines, next-generation vaccine technologies that reduce cold-chain dependencies, and fortified staples and drought-tolerant crops that protect calories in a hotter, hungrier world.

Movers and shakers who keep institutions working

These leaders steer scarce funds toward the highest-impact interventions and defend the mundane but vital systems: supply chains that reach the last mile, disease surveillance that catches outbreaks early, and maintenance that prevents infrastructure collapse at critical moments.

Workers on the ground

Community-embedded staff close the implementation gap that can derail grand plans: getting expectant mothers into prenatal care, finding zero-dose children, restoring basic mental-health services, and enforcing environmental rules that keep toxins out of children's bloodstreams.

Thinkers who get more good for less

These analysts use data to challenge assumptions, make trade-offs explicit, and identify interventions that deliver the largest returns in healthy life-years and human flourishing. They wrestle with the central question of our time: how to improve the most lives per dollar spent.

Beyond the list

Alongside the profiles, we produced in-depth reporting on pressing challenges and solutions: the acute need for trained midwives in an era of constrained aid; the fragile role of India as the world's major pharmaceutical supplier; and new, lower-cost approaches to preventing starvation. If this package inspires action, see the Guide to Giving for vetted ways to help.

The Future Perfect 25 is not a nostalgic plea for a bygone era of generosity. It answers the original journalistic question: what vital work is undercovered? These 25 women and men embody that mandate now—practical, persistent, and focused on keeping progress alive.

Credits

Writers: Marina Bolotnikova, Sara Herschander, Shayna Korol, Pratik Pawar, Izzie Ramirez, Sigal Samuel, Kenny Torrella, Paige Vega, Bryan Walsh.

Editorial lead: Bryan Walsh. Project manager: Izzie Ramirez. Editors: Marina Bolotnikova, Izzie Ramirez, Paige Vega, Bryan Walsh.

Copy editing & fact checking: Kim Slotterback, Isabelle Lichtenstein, Esther Gim, Sarah Schweppe. Art director: Paige Vickers. Illustrators: Michael Hoeweler, Nicole Rifkin, Mar Hernández, Claire Merchlinsky.