Bill Gates: Aid Cuts Could Cause a 'Tragic' Rise in Child Deaths — 4.8 Million Projected

Bill Gates Warns Aid Cuts Will Reverse Decades of Progress on Child Survival

Microsoft co-founder and philanthropist Bill Gates told AFP that recent, sharp cuts to international aid by wealthy Western countries are likely to push global child deaths higher this year — the first increase this century. Speaking from Seattle, Gates described the projected rise as "tragic," stressing that these reversals threaten gains made since the turn of the millennium.

Key Findings From the Goalkeepers Report

The Gates Foundation's annual Goalkeepers report forecasts that 4.8 million children will die before their fifth birthday this year, an increase of about 200,000 from 2024. The report links this deterioration to a 27% fall in aid for developing countries this year. Modeling by the Gates-funded Institute for Health Metrics and Evaluation (IHME) suggests that if global aid cuts of roughly 30% 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 said.

Where Gates Sees the Biggest Cuts

Gates singled out the United States as having implemented the deepest reductions, criticizing abrupt changes tied to what he described as Elon Musk's so-called "US Department of Government Efficiency (DOGE)" and the effective shutdown of parts of the US international development apparatus after President Trump's return to the White House. He said grants from the US Agency for International Development (USAID) were cut abruptly, creating what he called a "chaotic situation." Gates also said Britain, France and Germany have cut aid "disproportionately."

He said he is engaging directly with world leaders — including conversations with France's political leadership and discussions with President Trump — urging that aid losses be limited to modest reductions rather than the dramatic cuts being seen.

Impact On Vaccines And Global Health Programs

Gates, a major supporter of global vaccination efforts and the Gavi alliance, said he was disappointed the US did not renew its funding for Gavi in June. He criticized a video message from US Health Secretary Robert F. Kennedy Jr. to a Gavi fundraiser, saying it echoed "extremely debunked and misguided views" opposing childhood vaccines. Gates emphasized that, while the Gates Foundation works with all administrations, it strongly disagrees with anti-vaccine rhetoric.

He warned that reduced funding threatens progress against malaria, HIV, polio and other diseases. Independent research reported by AFP from the Barcelona Institute for Global Health estimated that more than 22 million people could die from preventable causes by 2030 if current US and European aid cuts persist.

Hope From New Medical Tools

Gates expressed cautious hope that new tools could help reverse the rise in child mortality within five years. He highlighted recently developed vaccines for respiratory syncytial virus (RSV) and pneumonia and noted the rollout in South Africa of lenacapavir, a twice-yearly HIV-prevention injection, as promising advances that could save many lives if supported and scaled.

Context And Philanthropic Influence

The Bill & Melinda Gates Foundation, founded in 2000, remains a major player in global health despite Melinda French Gates's departure following the couple's divorce. In May, Gates announced plans to give away his more than $200 billion fortune over the next two decades, completing the distribution by 2045. Jessica Sklair, a researcher on elite philanthropy at Queen Mary University of London, told AFP that Gates already wields "an enormous influence over the world of global health" and that aid cuts could increase his relative influence as public funding declines.

Bottom line: Gates warns that substantial aid reductions risk undoing decades of progress in child survival. While new vaccines and therapies offer hope, restoring and stabilizing international aid is critical to prevent a large rise in preventable child deaths worldwide.