In a recent statement, Bill Gates underscored the critical consequences of decreased foreign aid allocations from wealthy nations, noting that these cuts have contributed to a reversal in the longstanding global trend of declining child mortality. Drawing attention to data from 2025, Gates highlighted an alarming increase in deaths among children under five years old, a demographic for which mortality rates had been steadily falling for a quarter of a century.
Gates, co-founder of Microsoft and leading philanthropist through the Gates Foundation, attributed this setback largely to the foreign aid reductions implemented during former President Donald Trump's tenure. His annual letter to stakeholders expressed frustration over the fact that global health progress "went backward last year," emphasizing the rise in child deaths from 4.6 million in 2024 to 4.8 million in 2025.
The Gates Foundation's Goalkeepers Report provides a sobering projection of this trend, modeling potential future outcomes should health funding continue to shrink. According to their analysis, a 20% reduction in global health financing compared to 2024 levels could result in approximately 12 million additional child deaths by 2045. This projection is grounded in data curated by the Institute for Health Metrics and Evaluation, which informs the foundation’s strategic direction.
Despite the challenges outlined, Gates conveyed a cautious optimism, pointing to the transformative potential of artificial intelligence as a catalyst for future global health improvements. He acknowledged, however, that the upcoming five years will be difficult for governments and non-governmental organizations alike, as they face the dual pressures of expanding lifesaving interventions while contending with constrained financial resources.
In a pronounced commitment to address these challenges, Gates announced in 2025 his intention to allocate nearly all of his personal wealth, estimated at $100 billion, to the Gates Foundation. This initiative forms part of a broader plan to invest $200 billion over two decades towards enhancing global health efforts. Alongside this personal pledge, he has called on other billionaires to increase philanthropic contributions, especially in light of declining governmental aid.
At present, Gates holds a net worth of approximately $118 billion, placing him 16th on the Bloomberg Billionaire Index. He stepped down from Microsoft's board in March 2020 to focus more intensively on philanthropic endeavors.
Notably, Microsoft’s stock has a mixed short- and medium-term outlook according to Benzinga Edge Stock Rankings, suggesting potential volatility despite long-term positive expectations. However, these market indicators stand apart from the global health context that Gates emphasizes in his advocacy.
Gates has previously criticized cost-cutting strategies associated with Elon Musk's Department of Government Efficiency for their potential to increase preventable deaths. Musk challenged Gates' assertions, prompting closer analysis that Gates claims now substantiates the fatal impact of austerity on vulnerable children.
Foreign aid budgets, even at their historical peak, have constituted less than 1% of GDP in most donor countries, yet Gates stresses that restoring a portion of this funding is crucial to prevent further reversals in health outcomes. The ongoing dialogue between philanthropic leaders, governments, and institutions centers on how to balance fiscal responsibility with critical investments in human health.
As the global community confronts these complexities, Gates advocates leveraging technological innovation alongside renewed financial commitments to ensure sustainable progress and to counteract recent setbacks in child health worldwide.