The Gates Foundation has warned that the number of children dying before the age of five could increase for the first time in the century.
According to the Gates Foundation’s 2025 Goalkeepers Report released on December 4, the number is projected to rise by just over 200,000, to an estimated 4.8 million children this year.
“The number of children dying before their 5 th birthday is projected to rise for the first time this century, reversing decades of global progress, according to new data published today in the Gates Foundation’s 2025 Goalkeepers Report,” read part of the report.
Gates Foundation Warns Child Deaths Set to Rise to 4.8 Million
Additionally, the report warns that if global health funding cuts persist, up to 16 million more children could die by 2045.
It offered a roadmap for how targeted investments in proven solutions and next-generation innovations can save millions of children’s lives, preventing a reversal in progress in today’s constrained budget environment.
The chairman of the Gates Foundation, Bill Gates, emphasized the need to save children despite the Funding cuts.
“I wish we were in a position to do more with more because it’s what the world’s children deserve. But even in a time of tight budgets, we can make a big difference,” Bill Gates said.
“I’ll continue to advocate, however and wherever I can, for increased funding for the health of the world’s children—and for efficiencies that improve our current system. But with millions of lives on the line, we have to do more with less, now.”
In Kenya, community health worker Josephine Barasa continued volunteering in her community after losing her paid position, providing care and education to mothers and children.
“They could take away the money, but they couldn’t take me away from my women… The support systems may have disappeared, but the need has not. And neither have I,” she said.
Figures Projections
Projections by the Institute for Health Metrics and Estimates (IHME) show that if global health funding cuts of 20% persist, an additional 12 million children could die by 2045.
A 30% permanent cut would bring that toll to 16 million.
Gates described this as a turning point for global health, when the right choices can still save millions of lives.
“We could be the generation who had access to the most advanced science and innovation in human history—but couldn’t get the funding together to ensure it saved lives,” Gates said.
“By making the right priorities and commitments, and investing in high-impact solutions, I’m confident we can stop a significant reversal in child deaths and help ensure millions more children are alive in 2045.”
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In the report, Gates identified investments with the most significant potential to save millions of young lives.
He urged stakeholders to double down on the most effective interventions- primary health care, routine immunizations, and better vaccines.
Some of the high-impact interventions that offer exceptional returns, according to the report, are:
- For less than $100 per person per year, strong primary health care systems can prevent up to 90% of child deaths.
- Every $1 spent on vaccines returns $54 in economic and social benefits. Through Gavi, the Vaccine Alliance, more than 1.2 billion children have received lifesaving vaccines.
According to Gates, investing in the development of next-generation innovations could eliminate some of the deadliest threats to children, including malaria and pneumonia.
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Modelling in the report showed that sustained funding for these innovations could save millions of children by 2045:
- Next-generation vaccines for respiratory syncytial virus (RSV) and pneumonia could save the lives of 3.4 million children.
- New malaria tools could save an additional 5.7 million children, while long-acting HIV prevention options like lenacapavir could help drive infections and deaths toward zero in high-burden countries.
Trump Terminates USAID Grants to Kenya
This year, President Donald Trump’s administration terminated thousands of foreign assistance grants and awards provided through the U.S. Agency for International Development (USAID) as part of a broader effort to reduce the size of the federal government.
As part of a review of foreign aid spending, the U.S. State Department discontinued at least 10,000 grants and contracts from the USAID and the State Department.
This included programs previously classified as “life-saving activities” that were granted waivers from the foreign aid suspension.
The termination of the grants disrupted critical services such as healthcare, nutrition, and emergency relief, leaving some of the world’s most vulnerable populations without vital support and thousands jobless.
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