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The Gates Foundation has announced a $912 million pledge to the Global Fund to fight AIDS, Tuberculosis and Malaria.
Speaking at the 2025 Goalkeepers event on Monday, the Foundation Chair, Bill Gates said the funds aims to shore up lifesaving health initiatives at a time when global health funding has fallen to its lowest level in 15 years.
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Mr Gates said low global funding is threatening decades of progress in reducing child mortality.
He described the situation as a crossroads for the world and urged renewed commitment to saving children’s lives and eradicating preventable diseases.
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Mr Gates warned that millions of children’s lives are at stake, stressing that global leaders have a once-in-a-generation opportunity to reverse the decline.
“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,” he said.
“The choices they make now—whether to go forward with proposed steep cuts to health aid or to give the world’s children the chance they deserve to live a healthy life—will determine what kind of future we leave for the next generation.”
The gathering held in New York brought together more than 1,000 government, community, philanthropic and private sector leaders.
Health funding crisis
A study by the Institute for Health Metrics and Evaluation (IHME) revealed that global development assistance for health (DAH) fell by 21 per cent between 2024 and 2025, pushing funding to its lowest point since 2010.
The cuts, driven by donor countries struggling with debt, ageing populations, and domestic pressures, come despite evidence of major gains over the past two decades.
Global health investments since 2000 reduced child mortality, from 10 million to fewer than five million annual deaths.
Mr Gates warned that the current decline threatens to reverse that progress. However, he said he remained optimistic that governments could still make the right choices to save lives.
“What is happening to the health of the world’s children is worse than most people realise, but our long-term prospects are better than most people can imagine,” he said.
“I don’t expect most governments to suddenly restore foreign aid to historic levels, but I believe governments can and will do what’s needed to save as many children as possible.”
Foundation pledge
The Global Fund, regarded as one of the most effective lifesaving initiatives of the 21st century, is seeking commitments from governments and donors before its replenishment cycle closes in November.
Since its creation in 2002, the fund, has saved more than 70 million lives, reduced deaths from AIDS, TB and malaria by over 60 per cent, and strengthened global health security.
Mr Gates noted that every dollar invested in the fund delivers an estimated $19 in health and economic returns.
The new pledge brings the Gates Foundation’s total contribution to the Global Fund to $4.9 billion, making it one of its largest investments.
Roadmap for future
The 2025 Goalkeepers event focused on reigniting global commitment to child survival and outlined a roadmap to halve child deaths again by 2045.
The approach calls for renewed investments in proven initiatives such as the Global Fund and Gavi, the Vaccine Alliance, while also prioritising primary health care systems that can prevent, detect, and treat childhood illnesses early.
It further emphasises investing in research and development, alongside rolling out breakthrough innovations.
These include new approaches to combating malaria, such as preventing mosquitoes from carrying parasites and single-dose treatments, long-acting HIV drugs and prevention methods that replace daily pills, maternal vaccines against respiratory syncytial virus (RSV) and group B streptococcus (GBS), and artificial intelligence tools to deliver safer and cheaper medicines.
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Findings from the Gates Foundation and IHME suggest that sustaining global investments in child health and scaling innovations could cut child mortality in half again over the next 20 years.
Global Goalkeeper Award
The Goalkeepers Awards, part of the Gates Foundation’s Global Goals initiative, celebrate individuals and organisations driving progress towards the United Nations Sustainable Development Goals.
Through annual reports that share stories and data behind the Global Goals, the foundation aims to inspire a new generation of leaders, Goalkeepers, who raise awareness, hold leaders accountable, and drive action to achieve the goals.
At the event, the foundation presented its 2025 Global Goalkeeper Award to Spanish Prime Minister Pedro Sánchez for expanding Spain’s contributions to global health.
Under his leadership, Spain increased its contribution to the Global Fund by nearly 12 per cent and to Gavi by 30 per cent, while also hosting the International Conference on Financing for Development in June.
Other Goalkeepers Champions honoured for their contributions to advancing child health included Nigerian actress Osas Ighodaro, recognised for her malaria advocacy, and campaigners such as Abhay Bang and Rani Bang of India, David Beckham of the United Kingdom, Krystal Mwesiga Birungi of Uganda, Toni Garrn of Germany, John Green of the United States, Donald Kaberuka of Rwanda, Jerop Limo of Kenya, Reem Al-Hashimy of the United Arab Emirates, and Naveen Thacker of India.
Looking ahead
The New York gathering, themed “We Can’t Stop at Almost,” was co-hosted by musician Jon Batiste and actress Olivia Wilde, and featured contributions from scientists, faith leaders, community champions, and health workers from countries including Nigeria, Kenya, South Africa, Senegal, Uganda, Indonesia, and the United States.
Later this year, the Goalkeepers platform will expand to the Middle East for the first time, with a major convening scheduled for Abu Dhabi on 8 December.
The Gates Foundation said it will also release its 2025 Goalkeepers Report, which will focus on the impact of leaders’ decisions between now and year-end on the survival of children worldwide.
Earlier this year, Mr Gates announced that he would donate virtually all of his wealth to the foundation, with plans to spend $200 billion over the next 20 years before winding down its operations.
The funding will target three priorities: ending preventable deaths of mothers and babies, eradicating infectious diseases, and lifting millions out of poverty.
