SO FAR, 2025 was a terrible year for global health. The Trump administration reduces the financing of a certain number of international programs; Closing of the USAID, the main branch of government development; And withdraw the US members of the World Health Organization.
But a glow of hope arrived on May 8, when Bill Gates, president of the Gates Foundation, announcement That he will infuse the field in difficulty with most of his fortune – 200 billion dollars, which he built after having created Microsoft – to be spent by 2045. He also plans to close the foundations at that time.
Since Gates and his former wife, French Gates MelindaCreated the Foundation 25 years ago, the organization contributed more than $ 100 billion to the world’s causes, mainly healthy. The Gates Foundation has helped create two important international health organizations: Gaviwhich provides children from the world of vital vaccines, and the Global Fund, which focuses on the distribution of treatment for HIV, tuberculosis and malaria.
The just announced calendar of Gates represents an acceleration of the calendar of the foundation. When it was created, the Council agreed to sleep the organization about 20 years after the death of the doors.
Gates, who is 70 years old this year, told Time why he decided to accelerate his plans.
When did you start to think of closing the foundation earlier than expected before?
Over the past two years, I have discussed (CEO of the Gates Foundation) Mark Suzman and the Foundation Council on this subject. And we decided to double to obtain infectious diseases that have considerably reduced or eradicated, which is exciting.
It is ironic that the announcement ended up being at a time when funding for global health is in an incredible crisis due to many cuts and some that are discussed. It was not an answer to this. But perhaps my commitment to give all of this will remind people how important and effective these dollars are and the fundamental value of the reduction in infant deaths. It was therefore at the end of last year that I really put it on the board and I spoke of doubled.
It was also at the end of last year, in DecemberThat you had a three -hour dinner with Trump now president, and you said that you were “impressed” by his questions about polio and HIV. Was this discussion not part of your consideration to speed up your calendar?
In the two discussions that I had with President Trump since he was elected – on December 27 and February 5 – he supported our work in HIV and Polio completely. It is the Congress which will affirm the budget in the future, and historically, Pepfar, which was created by President Bush (to provide treatment against HIV) and Gavi had bipartite support, and less than 1% of the American budget goes to these things. Part of this funding has been cut right now, in fact in a fairly brutal way. We have to weigh the congress.
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I hope that we can obtain a large part of this restored funding, but we have challenges in many rich countries where budgets are very tight, and they are under pressure to increase defense budgets. Over the next four years, we will probably see an increase in the death of childhood for the first time since the beginning of the century, and I am very dedicated to changing things to help us come back to progress. We need global governments rich to restore part of this funding; We need more commitment to philanthropies to help. And incredible innovations mean all the money we can be used even more effectively. During the following 20 years, I am in fact quite optimistic, although we are in a terrible urgency at the moment.
Considering the US withdrawal of the WHO, could the Gates Foundation play a more important role in work with WHO to fill part of the financing gap?
WHO is a key partner for us. Actually (Director General of WHO) Tedros (Ghebreyesus) was in Singapore with me on Tuesday, and we were talking about the reorganization he crosses and the decisions he made. Who plays a big role in polio and most of the things we do in global health. Strangely, now that we have cut so much, the Gates Foundation is now the The largest unique donor to whom. I don’t think in the long term that it’s like that. Much of this is the work we do in polio, but we are funding a dozen things to whom.
But I think that ultimately, the United States will indicate everything he wants to see changed and resume as a member, because in many areas, which is critical, including whenever we have a potential pandemic. You know, we have financed a large part of the improvement in the Pandemic preparation of the WHO as a function of the lessons that are out of the cocovid vaccinal effort. I do not think the United States will return right away, but we will be someone to help negotiate a dialogue that ends up bringing the United States back there, which is precious to the world and the United States
To what extent are you concerned about the current global health situation, the United States making such large cuts in its contributions?
I would have guessed because the United States has problems with the deficit, we could see a drop from 15% to 20%. I would have said, okay, we must make sure to minimize the impact that has. I think it is ideal at this stage that we see it again.
There are certain proposals at the Congress of the Executive Branch which would represent a reduction of almost 80%. It would be tragic. We will see the deaths of children increase, and they have been falling at a record rate since 2000, going from 10 million to less than 5 million. We will see him go in the wrong direction, which means millions of additional deaths. Some cuts were quite abrupt.
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We will get a real gauge of this global health emergency in June in Brussels, for the replenishment in five years of Gavi: this entity that we started in 2000 with world -class governments to buy vaccines for the poorest children in the world. Metric will-can we raise as much as we raised five years ago, or will we be considerably lower than that? I must tell you, right now, it looks quite dark. Including the United States to buy these very cheap vaccines. These are $ 1 vaccines, and the majority of the reason why we have undergone death reductions, from around 10 million to five million is due to vaccines. In order not to be able to buy vaccines at $ 1 when we speak (something) which exceeds 1% of the American budget, I think it’s tragic. We will try to assert, try to keep the United States in HIV drugs, where it was very generous, starting with President Bush. The replenishment of the World Fund will come in the fall, and at the moment, it seems that it could be a disaster.
Other studies show that having an impact on health also requires treating non -medical factors, and the Gates Foundation has supported education and nutrition programs. What importance will be over the next 20 years?
If you are looking at the ventilation of foundation spending, which represents just over $ 100 billion in the past 25 years, the largest is by far a global health, with 35% of new low -cost tools and 35% helping to provide these tools.
The next step is education, which is around 15%. It has always been something where I got such a great education here in the United States, I felt like we should try to make this available to each student. We have done a lot with charter schools, programs and scholarships. Now we use AI to improve programs. We are able to obtain graduation levels.
Agriculture represents 8% of what we have done. The opportunity to make the seeds more productive, and more nutritious cult either by improving seeds or making a food fortification by adding micronutrients later – it is super important work. In particular in Africa where with demographic growth and climate change, the only way to help the poorest there – the majority of which are farmers – is improving their seeds and access to fertilizer.
One of the most amazing programs we have made is to take chickens in Africa and make the cross with very productive chickens from Europe and the United States to get many more eggs. Now we have more than 200 million chickens that have been delivered to women in Africa who help both nutritionally and help them economically. It is a very exciting area. Agricultural work has an impact as high as our health work.
To what extent did the Foundation discuss the objectives and the vision you set when you created it 25 years ago?
Progress of health is going well what I expected. Tens of millions of lives have been saved due to our work and our partnerships – more than 100 million lives. It’s not just us. There was a movement, and we were a central element.
In areas like education, we have done great things – the gradation rates have increased but not as miraculous. I expected that we have more impact on education and I did not know that we could have such incredible results in our health work. So we learn all the time. We have an innovation pipeline that is much stronger than ever. And we have the AI that will overcome this – both the discovery part and the delivery part. So I have fairly high expectations for the next 20 years, despite the financing urgency in which we are.