The purpose of this case study was to take a broad look at the effects of the Bill and Melinda Gates Foundation Global Health Program’s science, technology and innovation funding and policies on the ever changing scene of global health. Using sectoral systems of innovation and innovation in non-profit organizations as frameworks the foundations ability to absorb information and put it to use for the purpose of innovation was investigated. Due to its integral role in any situation where tasks are delegated, principal agent theory was used to investigate how they align their goals with those of their grantees. Finally possible implications for Science, Technology and Innovation strategies (intentionally or unintentionally) caused by the vast amount of money that the Gates Foundation has contributed to the field of health research, product development and also procurement and implementation were discussed. I argue that the Gates Foundation has had a massive impact on funding of innovation in the global health field, and the results of this funding are starting to emerge. A noticeable finding is the foundation’s ability to bring diverse actors together and marshal support for its initiatives. Furthermore, while the foundation appears to have been very successful in its dealing with the principal agent problem, they struggle to efficiently absorb information from their surroundings in terms of markets and partners, which could impact negatively on their ability to innovate.