A generation of progress, a choice to make
Bill Gates
Gates Notes (LinkedIn)
December 6, 2025
Summary
Bill Gates warns that child mortality is rising for the first time this century, with an estimated 4.8 million children projected to die before their fifth birthday in 2025—an increase of 200,000 from 2024's 4.6 million deaths.
Gates presents two possible futures: one where funding cuts of 20-30 percent lead to 12-16 million additional child deaths by 2045, and another where smart investments in primary health systems, efficient vaccines, and data-driven interventions save millions of lives.
Working with the Institute for Health Metrics and Evaluation at the University of Washington, the Gates Foundation quantified the stakes of proposed donor country budget reductions. Gates emphasizes that despite tight budgets globally—with many countries spending more on debt than health or education—strategic innovations can stretch limited resources.
He calls for doubling down on effective interventions like vaccines requiring fewer doses, using data to deploy malaria interventions where most needed, and supporting next-generation innovations that could end deadly threats to children permanently.
Quotes
"The death of a child is always a tragedy. But there's something especially devastating about a child dying of a disease we know how to prevent."
"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."
"This isn't just about money. It's about priorities, commitment, and choices."
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