Overview
- Deaths of children under five increased from 4.6 million in 2024 to 4.8 million in 2025, the first rise this century, according to Gates’ annual letter.
- Gates links the setback to sweeping foreign-aid reductions under President Donald Trump and cost-cutting tied to Elon Musk’s Department of Government Efficiency, a causality Musk has publicly challenged.
- The Gates Foundation’s Goalkeepers analysis, using IHME data, projects roughly 12–12.5 million additional child deaths by 2045 if health assistance falls 20% from 2024 levels.
- In 2025 Gates pledged about $100 billion to his foundation as part of a $200 billion plan to be spent within 20 years and called on other billionaires to accelerate giving.
- Gates says AI-fueled innovation gives him cautious optimism, yet he warns the next five years will be tough as health programs work to regain lost ground.