Gates urges renewed global health funding as governments set budgets

Bill Gates says he remains optimistic about global health and is urging leaders to increase health funding as governments finalize their budget decisions. He notes that child mortality has fallen dramatically since 2000, when more than 10 million children died before age five; today it is under 5 million. The trajectory is encouraging, but Gates says the next chapter will be written in the next round of public spending, and the choices lawmakers make now will determine whether millions more children survive and thrive.

A new analysis, conducted with the Institute for Health Metrics and Evaluation at the University of Washington, explored what would happen if funding is sustained at current levels and if investments are scaled to reach lifesaving innovations. The results were more hopeful than anticipated: with sustained or increased investments, the world could halve child deaths again over the next 20 years. The plan hinges on accelerating proven interventions and bringing a surge of affordable health innovations to scale. Among those innovations are malaria tools that block transmission, including approaches that prevent mosquitoes from carrying parasites; maternal vaccines to shield babies from respiratory infections—one of the leading causes of newborn deaths; and long-acting HIV therapies and prevention tools that reduce the burden of daily pill regimens. If these advances reach people who need them, HIV/AIDS could become a medical footnote rather than an ongoing global crisis.

Gates asserts that the toolkit is ready; global health institutions like the Global Fund and Gavi exist to help countries deploy vaccines, medicines and data-driven programs more cost-effectively. He noted that the Global Fund has helped save about 70 million lives since 2002. At the Global Fund replenishment in November, governments will decide how high of a priority global health is. His foundation will announce its contribution next week, signaling whether donors will meet a substantial funding goal.

Some low-income countries spend less than 3% of their domestic budgets on health, often constrained by debt burdens and high debt service payments. Gates called on global financial institutions to relieve that debt so more resources can be directed to health, arguing that sustainable progress requires both higher aid and smarter, country-led spending.

On the ground, Gates highlighted examples of people working to turn ideas into impact, such as Dr. Opeyemi Akinajo's AI-aided sensors for maternal and child health; Indonesia health minister Budi Sadikin's campaign to ensure access to care; and teenagers Maddie and Emile Leeflang from Utah who were inspired to advocate for health aid after volunteering in Kenya. In Gates’s view, these efforts illustrate a broader truth: progress in global health hinges on a coalition of scientists, policymakers and citizens, united by a simple commitment to protect the most vulnerable.

He framed the moment as a crossroads: funding models must evolve from a donor-recipient framework to sustainable, country-led approaches; the focus should be on core lifesaving programs, rapid deployment of transformative technologies, and a pathway out of outdated aid systems. Yet he warned that none of this will happen without rich countries committing a portion of their budgets to aid—particularly to child health—and that the next generation will judge the coming years by the lives saved or lost.

Ultimately, Gates said, humanity is at a turning point. What unfolds next will depend on political will as much as scientific progress. He closed with a personal appeal: as a grandfather, he hopes to see a world where future generations know about diseases like HIV, polio and sickle cell anemia only as history, not as ongoing threats. The roadmap is clear, and the time to act is now.