Bill Gates and the Gates Foundation are raising the alarm over the deadly impacts of international funding cuts in global health. Slashed budgets are projected to reverse decades of progress, causing the number of children dying before their fifth birthday to rise for the first time this century. An estimated 4.8 million children are expected to die this year, an increase of 200,000 deaths compared to last year.
“That is something that we hope never to report on, but it is a sad fact. And there are many causes, but clearly one of the key causes has been significant cuts in international development assistance from a number of high-income countries,” said Mark Suzman, CEO of the Gates Foundation, in a briefing with media this week.
Suzman specifically called out the U.S., the United Kingdom, France and Germany for “making significant cuts” to their support. Internationally, funding plunged 26.9% below last year’s levels, according to the philanthropy.
The Gates Foundation today released its annual Goalkeepers Report, which tracks progress on measures including poverty, hunger, access to clean water and energy, environmental benchmarks and other metrics.
The Seattle-based foundation worked with the University of Washington’s Institute for Health Metrics and Evaluation to model the effects of reduced assistance. The researchers found that if the cuts to aid persist or worsen, an additional 12 million to 16 million children could die over the next 20 years.

While offering dire projections, the document aims to be a call to action for governments and philanthropists large and small.
“This report is a roadmap to progress,” Gates writes, “where smart spending meets innovation at scale.”
The billionaire Microsoft co-founder calls out some specific areas that could yield the most benefit, including primary healthcare, routine immunizations, the development of improved vaccines and new uses of data.
Modeling in the report predicts that by 2045, better vaccines for respiratory syncytial virus (RSV) and pneumonia could save 3.4 million children, while new malaria tools could save an additional 5.7 million kids. Shots of lenacapavir could successfully prevent and treat HIV.
The foundation calls attention to the life-saving benefits of vaccinations as the U.S. Secretary of Health Robert F. Kennedy Jr. continues to undercut public support of vaccines.
With the backdrop of reduced federal funding for global humanitarian causes and backpedaling on vaccinations, Gates earlier this year announced plans to give away $200 billion — including nearly all of his wealth — over the next two decades through the Gates Foundation.
The Seattle-based organization, which celebrates its 25th anniversary this year, will sunset its operations on Dec. 31, 2045. The philanthropy is the world’s largest and has already disbursed $100 billion since its founding.
“If we do more with less now — and get back to a world where there’s more resources to devote to children’s health — then in 20 years, we’ll be able to tell a different kind of story,” Gates writes in the report. “The story of how we helped more kids survive childbirth, and childhood.”
