When we launched Vox’s Future Perfect section in 2018, it began with a simple question: “What topics would we write about if our only instruction was to write about the most important stuff in the world, particularly the most important stuff that isn’t already widely covered?”
In the years since, the “most important stuff” has grown to encompass everything from the existential risks (and benefits) of AI to the challenges of living a truly ethical life. And for each of the past three years, we’ve honored some of the most important and influential people in these spaces in our annual Future Perfect 50 packages.
But as we began thinking of how to organize the 2025 list, we realized it was time to go back to our fundamentals, because the most urgent story in our wheelhouse is the squeeze on foreign aid and on global health and development, which threatens to reverse some of the most important progress humanity has ever made.
Global aid is trending down just as needs rise. In the US, the evisceration of USAID has only added more strain. These shortfalls translate into rationed food aid, skeletal clinic hours, and broken supply chains.
Routine childhood immunization — still the best deal in public health — has plateaued, leaving more than 14 million “zero-dose” children wholly unprotected. Malaria tells the same story in harsher tones: an estimated 263 million cases and 597,000 deaths in 2023, overwhelmingly in Africa and largely among young children, with conflict, climate shocks, and funding gaps blunting new tools. Even polio — a disease the world was on the brink of banishing — is at risk of backsliding as the eradication program faces a 30 percent budget cut in 2026 and a funding gap through 2029.
In the face of all this, it might be tempting to give up. But while we can’t roll back the clock to the pre-Donald Trump days of more generous foreign aid, we can seize this moment as an opportunity to lean into what works best.
So for the 2025 Future Perfect 25, we’ve selected 25 changemakers who are innovating and implementing ways to keep progress on global health and development along four essential categories, which we’ve used to organize our list.
First, innovators who bend the cost curve. When budgets shrink, engineering has to pick up the slack: Think AI-assisted drug discovery that trims years and dollars; next-generation vaccine tech that stretches cold chains; fortified staples and drought-tolerant crops that sustain calories in a hotter, hungrier world.
Second, movers and shakers who prevent institutions from atrophying under pressure. These are the leaders pushing scarce funds toward the highest-impact interventions, and defending the boring but essential: supply chains that reach the last mile, disease surveillance that catches outbreaks early, maintenance that keeps basic infrastructure from failing at the worst moment.
Third, the soldiers on the ground. Workers embedded in communities close the implementation gap that can foil grand plans: getting mothers to prenatal care, reaching zero-dose kids, restoring basic mental-health services, enforcing environmental rules that keep toxins out of children’s blood.
Finally, the thinkers who figure out how to do the most good with less. They challenge priors with data, make trade-offs explicit, and find the interventions with the largest, clearest returns in healthy life-years and human flourishing. They’re answering the most important question of the moment: How do we improve the most lives for every dollar?
Beyond the list itself, we took the opportunity to deeply report several stories on some of the major challenges — and solutions — around global health, from the dire need for trained midwives in an aid-starved world to India’s precarious role as the world’s pharmacy to a new way to prevent starvation for less. And if this package inspires you to help, please check out our Guide to Giving.
The Future Perfect 25 is not a lament for a more generous era. It’s our 2025 answer to the question we started with: What’s the most important work in the world that isn’t getting enough attention? These 25 men and women are the embodiment of Future Perfect’s original mandate, and the most urgent version of it right now.
The future of global health is at stake. These 7 pioneers could revolutionize it.
Meet the Future Perfect 25: Innovators.
By: Izzie Ramirez, Sigal Samuel, Pratik Pawar, Shayna Korol, and Paige Vega
Free cancer treatment for all — and five other ideas to transform global health
Meet the Future Perfect 25: Movers and Shakers.
By: Izzie Ramirez, Sara Herschander, Sigal Samuel, and Shayna Korol
How 6 organizers are building effective global health solutions from the bottom up
Meet the Future Perfect 25: On the Ground
By: Bryan Walsh, Marina Bolotnikova, Kenny Torrella, Shayna Korol, and Pratik Pawar
The 6 big thinkers reshaping foreign aid, masculinity, and development
Meet the Future Perfect 25: Thinkers
By: Izzie Ramirez, Sara Herschander, Kenny Torrella, Marina Bolotnikova, and Bryan Walsh
How to deliver a baby with no supplies
These women save countless lives every year. We need more of them.
By: Sara Herschander
India’s drug industry saved the world once. Can it do it again?
The “pharmacy of the world” needs to reinvent itself.
By: Pratik Pawar
You can keep a child from starving for less than $100
Fighting hunger can feel impossible. But thanks to new innovations, it’s actually never been cheaper.
By: Sigal Samuel
Credits
Editorial lead: Bryan Walsh
Project manager: Izzie Ramirez
Editors: Marina Bolotnikova, Izzie Ramirez, Paige Vega, and Bryan Walsh
Copy editing & fact checking: Kim Slotterback, Isabelle Lichtenstein, Esther Gim, and Sarah Schweppe
Writers: Marina Bolotnikova, Sara Herschander, Shayna Korol, Pratik Pawar, Izzie Ramirez, Sigal Samuel, Kenny Torrella, Paige Vega, and Bryan Walsh
Art Director: Paige Vickers
Illustrators: Michael Hoeweler, Nicole Rifkin, Mar Hernández, and Claire Merchlinsky
Audience: Sydney Bergan, Gabby Fernandez, Bill Carey, and Kelsi Trinidad
Special thanks: Bill Carey, Nisha Chittal, Swati Sharma, Elbert Ventura
