Few outsiders have had as clear a view of the drug business as Gates. Over the past decade, Gates has relied on giants like Merck, Pfizer, and Sanofi-Aventis to provide the vaccines that are a lynchpin of his charitable work. He’s had a long-standing collaboration with GlaxoSmithKline over a malaria vaccine. The Bill & Melinda Gates Foundation recruited its last research head, Tachi Yamada, from Glaxo, where he had headed drug R&D. During his tenure, Yamada helped the Gates Foundation develop a meningitis vaccine from scratch to help people in parts of Africa. Yamada’s replacement, Trevor Mundel, hails from Novartis, where he ran clinical trials – a sign that some industry insiders say means that the Gates Foundation may be heading even further into the development of new vaccines and drugs.