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yesterday

Gates Report Projects First Rise in Under‑5 Deaths This Century as Health Aid Falls

The Gates Foundation links the setback to sharp donor cutbacks, calling for scarce funds to concentrate on primary care and routine vaccination.

Atlas, an expecting mother who is holding her 14-month-old son, attends a health clinic in August 2025 run by the French NGO Première Urgence Internationale in Ghazni province, Afghanistan, after its four other clinics closed due to US funding cuts.
A nurse assistant administers a malaria vaccine to a baby at Apac General Hospital in Uganda in April 2025. Data from the World Health Organization shows that children under 5 in Africa made up a substantial share of the 597,000 malaria deaths in 2023.
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A child suffering from diphtheria rests inside a ward at De Martino Public Hospital, following a diphtheria outbreak, in Mogadishu, Somalia August 13, 2025. REUTERS/Feisal Omar/File Photo

Overview

  • In its 2025 Goalkeepers report, using IHME modeling, the foundation projects roughly 4.8 million under‑5 deaths this year—about 200,000 more than 2024 and the first annual increase since 2000.
  • Global development assistance for health is estimated to be 26.9% below 2024 levels, with cuts led by major donors including the United States and the United Kingdom and reductions also reported in France and Germany.
  • Gates leaders say aid pullbacks are a primary driver of the reversal and urge prioritizing primary health care—costed at under $100 per person per year and capable of preventing up to 90% of child deaths—alongside routine immunization.
  • The report highlights vaccines as the best buy in health, estimating a $54 return for every $1 spent, and models that by 2045 next‑generation tools could save millions, including 5.7 million with improved malaria interventions and 3.4 million with RSV/pneumonia vaccines.
  • Scenario projections warn that persistent 20%–30% cuts could add 12–16 million child deaths by 2045, even as recent Global Fund pledges of $11.34 billion still leave risks of financing shortfalls.