Bill Gates Warns World Is 'Going Backwards' as Global Child Mortality Rises for First Time This Century

Microsoft co-founder and billionaire philanthropist Bill Gates has issued a sobering assessment of global development, stating that the world 'went backwards' in 2025. In his annual 2026 letter and a series of interviews at the World Economic Forum in Davos this week, Gates highlighted a historic and 'upsetting' reversal: the first year-on-year increase in global child mortality recorded in the 21st century.

According to data cited in his 'Optimism with Footnotes' letter, the number of deaths of children under the age of five rose from 4.6 million in 2024 to 4.8 million in 2025. Gates attributed this shift primarily to significant reductions in foreign aid from wealthy nations and the scaling back of international health programmes, as reported by Gates Notes.

The 'First Increase' of the Century

For over two decades, the steady decline of child mortality has been a cornerstone of global health success stories. However, the 200,000-death uptick in 2025 has been described by Gates as the metric he is 'most upset about.' He noted that while the world is technically becoming wealthier, the 'golden rule' of generosity toward the most vulnerable appears to be faltering.

The philanthropist warned that if global health funding continues to decline—with some projections suggesting a further 20 percent drop in the coming years—an additional 12 million children could die by 2045. This trajectory, he cautioned, represents a retreat from the 'miracle' of progress that saw child deaths halved since the year 2000, according to Observer.

Impact of Foreign Aid Cuts

Gates pointed specifically to the dismantling of key infrastructure, such as the US Agency for International Development (USAID), and cuts to global vaccine-buying funds like Gavi as catalysts for the regression. He argued that these financial withdrawals have an immediate and measurable impact on human life in Sub-Saharan Africa and Southeast Asia.

'I don't expect most governments to suddenly restore foreign aid to historic levels,' Gates wrote, though he stressed that restoring even a fraction of that funding is critical to preventing a slide back into what he termed a potential 'Dark Age' of stagnation, as cited by Unusual Whales.

AI as a Counter-Force to Regression

Despite the grim statistics regarding child survival, Gates maintained a degree of 'guarded hope,' largely driven by the rapid advancement of Artificial Intelligence (AI). He believes that AI can help the world 'do more with less,' particularly in regions facing severe shortages of healthcare workers.

At Davos, the Gates Foundation announced a new partnership with OpenAI to deploy AI-driven diagnostic tools in 1,000 primary health clinics across Africa over the next two years. 'AI is going to be a game-changer in expanding access to quality care,' Gates told reporters, noting that technology could help manage the delivery side of medicine where human personnel are currently lacking, as reported by The Times of India.

Accelerated Philanthropy and the 2045 Sunset

The warning comes as the Gates Foundation enters a new phase of accelerated spending. In May 2025, Gates announced he would donate 99% of his remaining fortune to the foundation, with the intent of spending down all resources and closing the organisation permanently by 31 December 2045.

This 'spend-down' strategy is designed to front-load $200 billion (£151 billion) in investments over the next 20 years to tackle the very regressions highlighted in this year's letter. By doubling annual spending to approximately $9 billion (£6.8 billion), the foundation aims to get the world 'back on track' by 2030.