Bill Gates said on Friday major cuts to foreign aid under the Donald Trump The government has reversed years of global health progress and contributed to a rise in infant deaths for the first time in decades.
The Microsoft Corp (NASDAQ:MSFT) co-founder and philanthropist has sharply criticized the foreign aid cuts made under Trump, warning that they have had deadly consequences for the world’s poorest children.
In his annual letter, Gates said global progress would come to a standstill in 2025 as funding from rich countries declined.
“What I’m most angry about is the fact that the world went backwards last year,” Gates wrote, pointing to a rise in deaths among children under five.
After steadily declining for 25 years, child mortality has risen from 4.6 million in 2024 to 4.8 million in 2025, according to Gates.
Gates has previously warned against aggressive cost-cutting measures – which involve many Elon Musk’s Ministry of Government Efficiency – could lead to avoidable deaths.
Musk publicly challenged Gates to provide evidence, which Gates says is now visible in the data.
Report warns of millions more deaths
The Gates Foundation’s latest Goalkeepers Report estimates that an additional 12 million children could die by 2045 if global health financing is cut by 20% from 2024 levels.
The analysis is based on modeling using data from the Institute for Health Metrics and Evaluation.
Gates noted that even at their peak, foreign aid budgets in most donor countries represented less than 1% of GDP. “It is critical that we restore some funding,” he wrote.
Gates gives hope for AI, with caveats
Despite the setbacks, Gates says he remains cautiously optimistic, citing innovation powered by artificial intelligence. “I believe the world will continue to improve – but that is harder to see today than it has been in a long time,” he wrote.
Still, Gates warned that the next five years will be particularly challenging as governments and nonprofits try to scale up lifesaving tools amid tighter budgets.
A $200 billion bet on philanthropy
In 2025, Gates promised to donate virtually all of his wealth – about $100 billion – to the Gates Foundation as part of a $200 billion plan to be spent over 20 years.
He also urged other billionaires to take action, arguing that philanthropy must grow as government support declines.
Currently, Gates has a net worth of $118 billion, which ranks him 16th on Bloomberg Billionaire Index. He resigned from Microsoft’s board in March 2020.
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