Gates says aid cuts will reverse progress and lead to an increase in child deaths this year

LONDON, Dec 4 The Gates Foundation has warned that around 200,000 additional children are expected to die before reaching their fifth birthday in 2025 compared to 2024, as reductions in international aid threaten decades of progress in child health. The foundation projects that child deaths will increase from roughly 4.6 million in 2024 to 4.8 million this year, marking the first rise in preventable child fatalities this century. Since 2000, the number of child deaths had been nearly halved.

"For many years, the global community steadily reduced child mortality. Now, rising challenges are causing that progress to reverse," said Bill Gates, chair of the foundation, in a foreword to the latest Goalkeepers report. The annual report monitors the United Nations sustainable development goals related to poverty reduction and health improvement. This years edition was delayed due to uncertainty in global health funding.

The decline in aid began with the United States earlier this year and has since extended to other major donors including the United Kingdom and Germany. Overall, global development assistance for health dropped by nearly 27% in 2025 compared with 2024, according to the report. Gates highlighted that these funding cuts are a primary reason for the setback in child mortality progress, alongside factors such as growing national debt and fragile healthcare systems.

Earlier in the year, Gates cautioned that reduced aid would result in higher child fatalities. If these cuts continue, the report estimates an additional 12 to 16 million child deaths could occur by 2045, depending on future funding levels. For 2025, the rise in child deaths could bring numbers close to those recorded in 2023, the latest year for which World Health Organization data is available. The figures are based on models developed by the Institute for Health Metrics and Evaluation at the University of Washington.

The foundation is urging governments and individuals to increase efforts and invest in both innovative tools and proven interventions, such as vaccination programs and primary healthcare, to strengthen child health outcomes worldwide.

Author's Opinion: A Reversal in Child Mortality Progress

The recent warning by the Gates Foundation highlights a troubling trend in global child health. After years of consistent progress, the increase in preventable child deaths in 2025 is a stark reminder of the fragility of these achievements. While global child mortality rates had been steadily declining, this shift marks the first rise in child fatalities in the 21st century. The primary driver of this reversal appears to be a significant reduction in international aid, which has been crucial to maintaining and expanding health initiatives worldwide.

The decline in aid from major contributors, including the United States, the United Kingdom, and Germany, is exacerbating already existing challenges in vulnerable healthcare systems. The reduction of nearly 27% in global development assistance for health is a concerning figure that threatens decades of progress in combating child mortality. As Bill Gates pointed out, this regression is not just a temporary setback but could potentially undo much of the gains made since 2000.

To avoid further backsliding, it is essential for governments to recommit to funding global health initiatives. Investment in existing solutions, such as vaccination programs and strengthening primary healthcare systems, is critical. This issue is no longer just about aid; it’s about global responsibility and the long-term sustainability of child health. Without decisive action, the toll on vulnerable children could be devastating for years to come.

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• Child deaths will rise this year as aid cuts reverse progress, says Gates