Gates Foundation CEO: Philanthropy 'Losing the Argument' As Child Mortality Rises After Aid Cuts

Mark Suzman, chief executive of the Bill & Melinda Gates Foundation, warned that the philanthropic sector is "losing the argument" about the value of international aid after reductions in development spending coincided with the first rise in child mortality this century.

Why Suzman Warns Aid Is Under Threat

Speaking alongside the release of his annual letter, Suzman said it has become "very easy in rich countries, broadly, to target foreign aid as a big lump" of spending in competition with urgent domestic priorities. He urged the sector to reframe its public message and emphasize the human, measurable impact of targeted health interventions.

"We’ve hopefully not lost [it], but I’m very conscious that we are currently losing the argument, and that is very damaging," Suzman said.

Evidence and Causes

Modeling from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington shows global child deaths from preventable causes fell from about 10 million in 2000 to 4.6 million in 2024, but rose by an estimated 200,000 in 2025. Suzman attributed that recent reversal primarily to the withdrawal of tens of billions of dollars in health and development funding by the United States and other wealthy countries.

He acknowledged the international aid system has "massive inefficiencies" and "lots of room for improvement," but argued that cuts in the specific health areas where the foundation works would be particularly harmful.

Foundations Strategy Before Wind-Down

The Gates Foundation announced last year that it will wind down over 20 years and close in 2045. To "accelerate its impact" before then, Suzman said the foundation will concentrate on three priorities: ensuring no mother or child dies of a preventable cause; eradicating polio and malaria while turning tuberculosis and HIV into manageable conditions; and lifting hundreds of millions out of poverty through education and agricultural reforms.

As part of that focus, the foundation plans to deploy the final $200 billion of Bill Gates’s Microsoft fortune in targeted efforts and to transition or end programs that have met their goals—such as some financial inclusion initiatives—so partners can carry them forward.

Calls For Cooperation And Concerns Over Influence

In his letter, Suzman called for "a new era of cooperation" to combat preventable deaths and diseases and said the foundation will step up work to build government capacity in low- and middle-income countries and to mobilize other donors and philanthropists before it closes.

Research published in BMJ Global Health raised concerns that the World Health Organization’s agenda may be influenced by growing reliance on Gates Foundation funding as traditional donor contributions fall; the WHO disputes that claim.

Political Context And Public Scrutiny

Bill Gates told the Financial Times that US President Donald Trump "likes the idea of finishing polio" and expressed hope that US global health funding could be restored. Gates warned that cuts to US contributions to the World Bank’s International Development Association (IDA) could trigger serious setbacks.

The article also noted renewed scrutiny of public figures following the release of documents related to Jeffrey Epstein. A Gates spokesman reiterated that Gates described meetings with Epstein as "a huge mistake" and called recent claims in released emails "absolutely absurd and completely false."