Gates Foundation reports first rise in child deaths this century as global health aid falls sharply
Global reductions in health funding could undermine decades of progress in child survival, potentially leading to millions of additional child deaths, according to the Gates Foundation.
The warning comes in its 2025 Goalkeepers report, "We Can't Stop at Almost."
For the first time this century, the number of children dying before the age of five is projected to increase. In 2024, an estimated 4.6 million children died before turning five. That figure is expected to rise to 4.8 million in 2025.
“That means more than 5,000 classrooms of children, gone before they ever learn to write their name or tie their shoes… It doesn't have to be like this,” Bill Gates, chair of the Gates Foundation, said.
The report attributes the rise to a significant decline in global development assistance for health.
The World Health Organisation (WHO) estimates that external health aid will decrease by 30% to 40% in 2025 compared to 2023, severely disrupting health services in low- and middle-income countries (LMICs).
Projections in the report suggest that continued funding cuts of 20% could result in an additional 12 million child deaths by 2045. If the cuts reach 30%, the figure could rise to 16 million.
“If we take this path, we’re the generation that almost ended preventable child deaths. Almost eradicated polio. Almost wiped malaria off the map. Almost made HIV history… But we can’t stop at almost. We know kids are dying. We know why. And we know how to stop it,” the report stated.
Amidst significant aid cuts by the United States government under President Donald Trump, the Microsoft founder has pledged $200 billion of his wealth to charity and revealed earlier this year that most of it will be directed towards Africa, with the main goal of ending preventable deaths of mothers and babies, eliminating deadly infectious diseases, and reducing poverty across the continent over the next two decades.
Funding cuts have resulted in a 70% reduction in some countries for vital services like disease surveillance, immunisation, maternal care, and emergency preparedness and response, according to WHO survey data from 108 LMICs gathered in March 2025.
The Goalkeepers report outlines several interventions with high potential to save lives. These include strengthening primary health care systems, maintaining routine immunisation programmes, improving vaccines, and using data to drive better decision-making.
According to the report, primary health care systems that cost under $100 per person annually could prevent up to 90% of child deaths.
Since 2000, the number of child deaths worldwide has decreased by half as a result of vaccines being given to the most vulnerable children, the report noted.
“And every dollar spent on immunisation gave countries a return of $54.”
This story is written and edited by the Global South World team, you can contact us here.
