Bill Gates warns child deaths may rise after Trump-era funding cuts

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By Ashleigh Furlong and Janice Kew

 

Billionaire Bill Gates said cuts to global health funding from donors including the US are likely to contribute to the first increase in childhood deaths in at least 25 years. 

More than 200,000 additional children under 5 are expected to die this year, according to modeling in the Gates Foundation’s annual Goalkeepers report. Cuts by President Donald Trump’s administration are “part of that picture” contributing to the expected rise in deaths, Gates said in an interview.

 

The Gates Foundation, which plans to wind down operations by 2045, has accelerated spending since May as it pushes to drive progress. The latest report argues for scaling up proven tools — from dual-insecticide bed nets for malaria to new vaccines for respiratory syncytial virus and long-acting HIV prevention drugs like Gilead Sciences Inc.’s lenacapavir — to prevent millions of avoidable deaths.

 

Global aid funding has dropped almost 27 per cent this year, putting pressure on programs that had relied heavily on sustained support. The US cuts have drawn the most attention, but the UK, France and Germany have also slashed spending. 

 

The consequences are immediate, Gates said. In Nigeria, for example, donor support once paid for more than 8,000 workers involved in finding and treating tuberculosis cases. “Now all of that’s come to an end,” he said. “That’ll lead, that alone — one disease, one country — to tens of thousands of deaths.” 

 

Even so, Gates expressed guarded optimism. He pointed to “positive signs” in the State Department’s new global health plan, part of the America First Global Health Strategy released in September. 

 

The strategy outlines a shift toward bilateral agreements that give the US greater control over how its aid is used. The administration has also said it plans to withdraw from the World Health Organization, a move that would force the agency into a major reckoning.

 

The former Microsoft CEO said he has spoken with Trump about the need to preserve funding and that the president had a positive response. 

 

“I have had direct conversations with President Trump saying that although a modest cut on the 10 per cent to 20 per cent level could be justified in terms of new ideas about efficiency, that once you get beyond that level, the US will have some culpability in the increase in deaths and he’s responded favorably to that, but we don’t have a plan to get the spending all back in place,” Gates said.

 

“I do think that Congress cares and President Trump cares, but we still don’t have a full resolution of what the funding flows will look like,” he said.  

‘Best Buy’

The Goalkeepers report looks at what is the most effective use of funding, finding that routine vaccination is still the “best buy in global health.” Vaccines have come under scrutiny from US Health Secretary Robert F Kennedy Jr. The US Centers for Disease Control and Prevention has suggested shots may cause autism, rejecting longstanding medical consensus on the topic. 

 

The criticism has a knock-on effect, according to the Foundation’s chair. “Vaccine skepticism out there on the Internet does get to the entire globe,” Gates said.

 

Vaccine hesitancy can be even more deadly in poorer countries, he argues. “In the United States, because kids are well nourished and they have good access to health care, you can actually be fairly lax and your deaths will be like 5 per 1,000 of kids who are infected with measles, whereas in Africa it would be more like 250 per 1,000.”  

 

The Gates Foundation plans to double its spending over the next 20 years. Still, Gates himself has been clear that a single funder cannot make up for the US pullback. And while traditional aid recipients are increasingly looking to become self-sufficient, such a shift will likely take many years. 

 

“For the African countries that are fairly poor, they are in no position to become self-sufficient,” Gates said. “That’s a 20-year goal, not a four-year goal.”