Last year didn’t go as Bill Gates had hoped. As a philanthropist who has spent billions in poor countries to improve everything from health care and education to climate change action, Gates could only watch as the Trump administration slashed large amounts of foreign aid deals.
The Microsoft co-founder has criticized cost-cutting measures, many of which were implemented under Elon Musk’s Department of Government Efficiency (DOGE). As he warned that the action could directly lead to the death of children, Tesla CEO Musk demanded proof.
Writing in his annual letter this year, the founder of the Gates Foundation was optimistic but clear, writing: “I believe the world will continue to improve – but it is harder to see today than it has been for a long time.”
He added: “What saddens me the most is that the world has gone backwards in the last year on a key metric of progress: the number of deaths of children under the age of five. In the last 25 years, those deaths have fallen faster than at any point in history. But in 2025, they will decrease from 4.6 million in 2025-2025 to 4.6 million for the first time this century. From rich countries to poor countries.
Last month, the Gates Foundation’s Goalkeeper report found that a 20 percent reduction in development aid for health (including government spending) from 2024 levels could lead to 12.5 million more child deaths by 2045, according to bespoke modeling based on data from the Institute for Health Metrics and Evaluation.
“Friends and colleagues often ask me how I stay optimistic in an age so challenging and so polarizing,” Gates wrote. “My answer is this: I’m still optimistic because I see what artificial intelligence-driven innovation will bring.”
But, that optimism comes with a deadline, or as Gates puts it, “my optimism has footnotes.”
“The next five years will be difficult as we try to get back on track and work to scale new life-saving devices,” Gates continued. “As tough as last year was, I don’t believe we’re going back to the dark ages.”
“I believe that, within the next decade, we will not only get the world back on track but enter a new era of unprecedented progress.”
Fund the gaps
In 2025, Gates announced his $200 billion moonshot: he was donating “virtually all of it.” [his] fortune”—about $100 billion—to his foundation. It was the largest philanthropic commitment in modern history, and came with strings attached. The fund (made up of its current endowment and projected growth) must be spent over the next 20 years.
When Gates made the announcement this year, his intentions had been clear for years. In 2010 Gates, his wife Melinda French Gates and Berkshire Hathaway co-founder Warren Buffett launched the Giving Pledge, a public commitment to philanthropy, signed by philanthropist Mackenzie Scott and Airbnb CEO Brian Chesky.
In an effort to bridge the gap in government funding, Gates is calling on fellow wealthy philanthropists. He wrote: “This idea of treating others as you would want to be treated doesn’t just apply to rich aid-giving countries. It should also include philanthropy from the rich—both domestically and globally to help those in need—which must grow exponentially in a world with record numbers of billionaires and centennials.”
Oxfam’s Billionaires Report, recently released in January 2025, revealed that the number of billionaires in 2024 rose to 2,769, up from 2,565 the previous year. It also said it expects at least five more to reach trillionaire status a decade from now.
Gates added: “I know that the cuts will not be reversed overnight, although aid represents less than 1% of GDP even in the most generous countries. But it is important that we restore some funds.”
This story was originally featured on Fortune.com
