Bill Gates: World 'Went Backwards' in One Big Way

Bill Gates thinks the world just flunked a basic test of progress. In his annual letter, the Microsoft co-founder notes that global child mortality rose in 2025 for the first time this century, and he links that reversal directly to reduced aid from wealthy nations. Deaths of children under 5 climbed from 4.6 million in 2024 to 4.8 million in 2025, he writes, after decades in which that number had been falling faster than at any other time in history. "The thing I am most upset about is the fact that the world went backwards." Gates, however, sees hope for progress on other fronts, Fortune reports, largely because of advancements in artificial intelligence.

Gates has been a sharp critic of the Trump administration's foreign aid cutbacks, many of which were carried out through Elon Musk's Department of Government Efficiency; he has warned the reductions will cost young lives, which Musk disputed. A recent Gates Foundation "Goalkeepers" analysis projects that if development assistance for health drops 20% from 2024 levels and stays there, 12.5 million more children could die by 2045. AI will accelerate medical and other innovations, Gates writes, while tempering his optimism with a projection: He expects the next five years to be difficult as global health systems attempt to regain lost ground and expand access to new vaccines, treatments, and other tools.

He's moved to fill part of the gap himself. Gates pledged "virtually all" of his fortune last year, about $100 billion, to the Gates Foundation, bringing its planned spending to roughly $200 billion over the next 20 years. That made it the largest modern philanthropic commitment, per Fortune. He's also urging other ultra-wealthy donors, including the hundreds of new billionaires counted in a recent Oxfam report, to increase giving both at home and abroad, arguing that philanthropy should grow "rapidly" in an era of record private fortunes. He also said he's using AI "to better understand my own health," per GeekWire. Fortune has the text of Gates' letter here.