Philanthropist and Microsoft co-founder Bill Gates has issued a stark warning, stating that reductions in international aid by wealthy Western countries are leading to a tragic increase in child deaths globally. In a video interview from Seattle on Thursday, Gates described the projected rise as a devastating setback after decades of progress.
A 'Tragic' Reversal in Child Survival
According to the annual Goalkeepers report released by the Bill & Melinda Gates Foundation, the number of children dying before their fifth birthday is projected to increase to 4.8 million this year. This marks a rise of 200,000 deaths since 2024 and represents the first increase in child mortality this century. Gates called this reversal a "tragedy," noting that annual deaths had steadily fallen from around 10 million at the turn of the millennium.
The report links this alarming trend directly to a 27 percent plummet in aid for developing countries this year. This drastic cut threatens hard-won progress against deadly diseases like malaria, HIV, and polio. Gates, a major funder of global health programmes, placed particular blame on the United States for making the deepest cuts.
Chaotic Cuts and Political Pressure
Gates singled out the so-called US Department of Government Efficiency (DOGE), championed by billionaire Elon Musk, criticising the "chaotic situation" it created. He stated the department was "responsible for a lot of deaths" after it abruptly cut off grants from the US Agency for International Development (USAID). The agency has been dismantled since Donald Trump returned to the White House in January 2025.
The 70-year-old philanthropist revealed he is actively engaging with political leaders to reverse the trend. "I'm talking to President Trump about encouraging him to restore aid so that it is at most a modest cut — I don't know if I'll be successful with that," Gates said. He also expressed disappointment that the US did not renew its funding for the Gavi vaccine alliance in June and criticised US Health Secretary Robert F. Kennedy Jr.'s "extremely debunked and misguided views" on childhood vaccines.
Long-Term Consequences and a Path Forward
The long-term outlook is grim if cuts persist. Modelling by the Gates-funded Institute for Health Metrics and Evaluation suggests that if global aid reductions of around 30 percent become permanent, an additional 16 million children could die by 2045. "That's 16 million mothers who are experiencing something that no one wants to or should have to deal with," Gates emphasised.
While acknowledging that "rich world budgets are very tight," Gates regretted that European nations like Britain, France, and Germany have also "disproportionately" slashed international aid. He mentioned discussing the tough budget situation directly with leaders in France.
Despite the bleak assessment, Gates expressed hope for the future, pointing to new medical tools. He highlighted new vaccines for respiratory syncytial virus (RSV) and pneumonia, as well as a groundbreaking twice-a-year HIV-prevention injection called lenacapavir, which began rollout in South Africa this week. He believes these innovations could help bring child mortality rates back down within the next five years.
The report's findings are bolstered by other research, including a study from the Barcelona Institute for Global Health, which determined that more than 22 million people could die from preventable deaths by 2030 due to the combined US and European aid cuts. As Gates prepares to give away his over $200 billion fortune by 2045, experts note that his influence in global health is immense, but private philanthropy alone cannot fill the gap left by government retreat.
