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Bill Gates during the Goalkeepers 2025 event in New york. /Gates Foundation.

Capital Health

Bill Gates Unveils Roadmap to Halve Child Deaths Again by 2045, Urges World Leaders To Act

NEW YORK, Sep 27 – Standing before more than 1,000 government, community, philanthropic and private-sector leaders at the 2025 Goalkeepers event, Gates Foundation Chair Bill Gates issued a stark but hopeful call: save millions of children’s lives and make some of the deadliest diseases history by 2045.

“Humanity is at a crossroads. With millions of children’s lives on the line, global leaders have a once-in-a-generation chance to do something extraordinary,” Gates said. “The choices they make now—whether to continue with steep cuts to health aid or give the world’s children the chance they deserve—will determine the future we leave the next generation.”

The appeal came amid sharp funding reductions. Donor countries facing high debt levels and domestic pressures have cut development assistance for health by 21 percent between 2024 and 2025, pushing it to a 15-year low, according to the Institute for Health Metrics and Evaluation. If the cuts persist, they threaten decades of progress that halved child mortality since 2000—from 10 million to fewer than 5 million deaths annually.

A Major New Commitment

To underscore the urgency, Gates announced a $912 million pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria for its 2026-2028 replenishment. Since 2002 the Global Fund has saved more than 70 million lives and reduced deaths from AIDS, TB and malaria by over 60 percent. Each dollar invested delivers an estimated $19 in health and economic returns.

The foundation’s new pledge brings its total commitment to the Global Fund to $4.9 billion and aims to galvanise governments, philanthropists and the private sector ahead of the fund’s Eighth Replenishment, co-hosted by South Africa and the UK later this year.

A Roadmap to a Healthier Future

Gates outlined a roadmap showing how sustained investments and scaled innovations could cut child deaths in half again over the next 20 years. Key elements include:

  • Renewing support for proven initiatives such as the Global Fund and Gavi to secure vaccines, medicines and treatments and help countries transition to self-reliance.
  • Prioritising primary health care to prevent, detect and treat childhood illnesses early.
  • Investing in breakthrough innovations such as new malaria approaches, long-acting HIV drugs, maternal vaccines against RSV and group B strep, and artificial intelligence to deliver medicines faster and more cheaply.

Celebrating Champions

The foundation also honoured Spain’s Prime Minister Pedro Sánchez with the 2025 Global Goalkeeper Award for increasing contributions to the Global Fund and Gavi and hosting June’s landmark International Conference on Financing for Development.

Nine Goalkeepers Champions from across the world—including Dr Abhay and Dr Rani Bang (India), Krystal Mwesiga Birungi (Uganda), John Green (USA), Osas Ighodaro (Nigeria) and Jerop Limo (Kenya)—were recognised for their ingenuity, resilience and community-led solutions.

Looking Ahead

The event, co-hosted by musician Jon Batiste and actress Olivia Wilde under the theme “We Can’t Stop at Almost,” featured leaders, scientists and activists from Bangladesh, Indonesia, Kenya, Madagascar, Nigeria, Senegal, South Africa, Uganda and the United States.

Later this year Goalkeepers will expand to the Middle East for the first time, convening leaders and innovators in Abu Dhabi on 8 December. Ahead of that, the foundation will release its 2025 Goalkeepers Report highlighting how decisions taken before year-end will shape the survival of millions of children.

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