The Bill & Melinda Gates Foundation will contribute $912 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria, co-founder Bill Gates announced Monday, warning that steep government aid cuts threaten decades of progress in global health.
Speaking at a Reuters Newsmaker event in New York ahead of the foundation’s annual Goalkeepers gathering, Gates said the world is “at a crossroads,” with millions of children at risk if international health funding continues to fall.
“A kid born in northern Nigeria has a 15% chance of dying before the age of five,” Gates said. “You can either be part of improving that or act like that doesn’t matter.”
The new pledge matches the foundation’s 2022 donation, when the Geneva-based Global Fund last ran a three-year fundraising cycle. It comes as global development assistance has dropped to a 15-year low, according to the Institute for Health Metrics and Evaluation, with funding down 21% between 2024 and 2025.
Gates emphasized that philanthropy alone cannot replace government commitments: “I am not capable of making up what the government cuts, and I don’t want to create an illusion of that.”
The Microsoft co-founder, who has vowed to give away most of his $200 billion fortune by 2045, highlighted the urgent need to sustain funding for organizations such as the Global Fund and Gavi, the Vaccine Alliance. He pointed to innovations like the long-acting HIV prevention drug lenacapavir as examples of how investment could transform health outcomes.
Progress since 2000 has halved global child mortality, saving an estimated five million lives annually. But without renewed support, those gains could stall, Gates warned. Still, he expressed optimism that millions more lives could be saved by 2045 if funding and innovation are prioritized.
At the Goalkeepers event, the foundation awarded Spanish Prime Minister Pedro Sánchez its annual Global Goalkeeper Award. Unlike many governments that have reduced aid, Spain increased its contributions this year — by 12% to the Global Fund and 30% to Gavi.
The Goalkeepers gathering, which tracks progress toward the U.N.’s 2030 Sustainable Development Goals, typically releases an annual report. This year’s edition has been postponed until December, when global health funding projections are expected to be clearer.
“What’s happening to the health of the world’s children is worse than most people realize,” Gates said, “but our long-term prospects are better than most people can imagine.”
