As 2025 unfolds, the global health landscape appears increasingly bleak, largely due to significant funding cuts initiated by the Trump Administration. The administration has not only slashed funding for various international programs but has also shuttered USAID, the government’s primary aid development arm, and withdrawn U.S. membership from the World Health Organization (WHO). However, amidst this turmoil, a beacon of hope emerged on May 8, when Bill Gates, the co-founder of Microsoft and chair of the Gates Foundation, announced a groundbreaking commitment to infuse the global health sector with $200 billion of his personal fortune, which he plans to distribute by 2045.
This announcement marks a pivotal moment for the Gates Foundation, which has already contributed over $100 billion to global health initiatives since its inception 25 years ago. The foundation played a crucial role in establishing two vital international health organizations: GAVI, which provides lifesaving vaccines to children worldwide, and the Global Fund, which focuses on distributing treatments for HIV, tuberculosis (TB), and malaria. Gates’ newly announced timeline accelerates the foundation’s original plan to sunset about 20 years after his and his former wife Melinda French Gates’ deaths.
During a candid interview with TIME, Gates, who turns 70 this year, explained his decision to expedite the foundation’s closure. “Over the last two years, I’ve been talking with [Gates Foundation CEO] Mark Suzman and the foundation board about this. And we decided to double down to get some infectious diseases either dramatically reduced or eradicated, which is exciting,” he said. He acknowledged the irony of making such a commitment at a time when global health funding is in crisis, but he hopes that his pledge will remind people of the importance and effectiveness of investing in health.
In the wake of his announcement, Gates also reflected on his discussions with President Trump, noting that the president was supportive of efforts in HIV and polio during their meetings in December 2024 and February 2025. “It’s Congress who will set the budget going forward,” Gates explained, highlighting the bipartisan support historically enjoyed by initiatives like PEPFAR, which was created by President George W. Bush to provide HIV treatments.
However, the situation remains precarious. The executive branch has proposed cuts to global health funding that could reach as high as 80%. Gates expressed his concern, stating, “We are going to see deaths from children go up, and they have been going down at a record rate since 2000.” He emphasized the urgent need for rich countries to restore funding and for philanthropies to increase their engagement in addressing global health challenges.
Gates is particularly worried about the upcoming GAVI five-year replenishment conference scheduled for June 2025 in Brussels. This meeting will serve as a critical gauge for the future of global health funding. “The metric will be—can we raise as much as we raised five years ago, or will we be substantially below that?” he questioned. With the potential for increased childhood deaths looming, Gates is adamant that the U.S. must continue to invest in inexpensive vaccines that have historically saved millions of lives.
In addition to his focus on health, Gates has also outlined the foundation’s spending priorities over the past 25 years, with 35% allocated to creating new, low-cost health tools and another 35% dedicated to their delivery. Education has received about 15% of the foundation’s funding, while agriculture has accounted for 8%. Gates noted the importance of improving agricultural practices, particularly in Africa, where many farmers struggle due to climate change and population growth. He highlighted a successful initiative that has distributed over 200 million chickens to women in Africa, enhancing both nutrition and economic stability.
Reflecting on the foundation's impact, Gates expressed pride in the progress made in global health, stating, “Tens of millions of lives have been saved because of our work and through our partnerships—over 100 million lives.” While he acknowledged that educational improvements have not been as pronounced, he remains optimistic about leveraging artificial intelligence to enhance learning outcomes.
As the global health community grapples with significant funding cuts and the ramifications of U.S. withdrawal from the WHO, Gates’ commitment to philanthropy stands out as a crucial lifeline. He is now the largest single donor to the WHO, a position he believes should not be the long-term solution. “I don’t think in the long run that’s the way it should be,” he asserted, emphasizing the importance of a collaborative approach to global health.
Despite the challenges ahead, Gates remains hopeful about the future. “Over the next 20-year period, I am actually quite optimistic, although we are in an awful emergency right now,” he said. With his significant financial commitment and a renewed focus on infectious diseases, Gates aims to inspire a resurgence in global health funding and ultimately save countless lives.
As the world watches this unfolding situation, the success of Gates’ initiatives and the response of governments and organizations will be critical in determining the future of global health. The stakes are high, but with renewed commitment and collaboration, there is potential for transformative change.
