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Bill Gates Will Close Gates Foundation by 2045, Give Fortune to Global Health

Bill Gates Will Close Gates Foundation by 2045, Give Fortune to Global Health

So far, 2025 has been a terrible year for global health. The Trump Administration is slashing funding to a number of international programs; closing down USAID, the government's major aid development arm; and withdrawing U.S. membership from the World Health Organization.
But a glimmer of hope arrived on May 8, when Bill Gates, chair of the Gates Foundation, announced that he will be infusing the struggling field with most of his fortune—$200 billion, which he built after creating Microsoft—to be spent by 2045. He also plans to close down the foundation at that time.
Since Gates and his former wife, Melinda French Gates, created the foundation 25 years ago, the organization has contributed more than $100 billion to global causes, primarily in health. The Gates Foundation helped to create two important international health organizations: GAVI, which provides the world's children with lifesaving vaccines, and the Global Fund, which focuses on distributing treatments for HIV, TB, and malaria.
Gates' just-announced timeline represents an acceleration of foundation's timetable. When it was created, the board agreed to sunset the organization about 20 years after the Gates' deaths.
Gates, who turns 70 this year, spoke with TIME about why he decided to speed up his plans.
When did you start thinking about closing the foundation earlier than you previously planned?
Over the last two years, I've been talking with [Gates Foundation CEO] Mark Suzman and the foundation board about this. And we decided to double down to get some infectious diseases either dramatically reduced or eradicated, which is exciting.
It is ironic that the announcement ended up being at a time where the funding for global health is in incredible crisis because of a lot of cuts being made and some that are being discussed. This was not a response to that. But perhaps my commitment to give all of it away will remind people how important and how effective these dollars are, and the basic value of reducing childhood deaths. So it was late last year that I really put it to the board and talked about doubling down.
It was also late last year, in December, that you had a three-hour dinner with now-President Trump, and you've said you were 'impressed' with his questions about polio and HIV. That discussion wasn't part of your consideration to accelerate your timeline?
In the two discussions I had with President Trump since he was elected—on Dec 27. and Feb. 5—he was quite supportive of our work in HIV and polio. It's Congress who will set the budget going forward, and historically, PEPFAR, which was created by President Bush [to provide HIV treatments] and GAVI had bipartisan support, and less than 1% of the U.S. budget goes to these things. Some of that funding has been cut off right now, in fact in a pretty abrupt way. We need to get Congress to weigh in.
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I am hopeful that we can get a lot of that funding restored, but we do have challenges in a lot of rich countries where budgets are very tight, and they are under pressure to increase defense budgets. Over the next four years, we are likely to see an increase in childhood deaths for the first time since the turn of the century, and I am very dedicated to changing things to help us get back to making progress. We need rich world governments to restore some of this funding; we need more engagement by philanthropies to help out. And incredible innovations mean whatever money we have can be used even more effectively. Over [the next] 20-year period, I am actually quite optimistic, although we are in an awful emergency right now.
Given the U.S. withdrawal from the WHO, could the Gates Foundation play a bigger role in working with the WHO to fill in some of the funding gap?
The WHO is a key partner for us. In fact [ WHO director general] Tedros [Ghebreyesus ] was in Singapore with me on Tuesday, and we were talking about the reorganization he is going through and decisions he has made. WHO plays a big role in polio and most of the things we do in global health. Strangely, now that U.S. cut so much, the Gates Foundation is now the largest single donor to WHO. I don't think in the long run that's the way it should be. A big part of that is the work we do in polio, but we fund a dozen things at WHO.
But I think eventually the U.S. will state whatever it wants to see changed and resume as a member, because in so many areas, WHO is critical, including whenever we have a potential pandemic. You know, we funded a lot of the improvement pandemic preparedness of the WHO based on lessons that came out of the COVID vaccine effort. I don't think the U.S. will go back in right away, but we'll be somebody to help broker a dialogue that eventually gets the U.S. back there, which think is valuable to the world and U.S.
How concerned are you by the current situation in global health, with the U.S. making such big cuts in its contributions?
I would have guessed because the U.S. does have problems with the deficit, we might see a 15%-20% cut. I would have said, okay, we need to make sure we minimize the impact that has. I think it's ideal at this point that we get back to that.
There are some proposals to Congress from the executive branch which would represent an almost 80% cut. That would be tragic. We are going to see deaths from children go up, and they have been going down at a record rate since 2000, from 10 million to under 5 million. We are going to see it go the wrong way, and that means millions of extra deaths. Some of the cut-offs have been quite abrupt.
We will get a real gauge of this global health emergency in June in Brussels, for the five-year replenishment of GAVI: that entity we started in 2000 together with rich world governments to buy vaccines for the world's poorest children. The metric will be—can we raise as much as we raised five years ago, or will we be substantially below that? I have to tell you, right now, it looks pretty grim. Including getting the U.S. to buy these very inexpensive vaccines. These are $1 vaccines, and the majority of the reason we had reductions in deaths from around 10 million to five million is because of vaccines. To not be able to buy $1 vaccines when we are talking [about something] that is well under 1% of the U.S. budget, I think that's tragic. We will try to make the case, try keep the U.S. in HIV medicines, where they have been very generous, starting with President Bush. The Global Fund replenishment will come in the fall, and right now, it all looks like it could be a disaster.
More studies are showing that making an impact on health requires addressing non-medical factors as well, and the Gates Foundation has supported programs in education and nutrition. How important will these be over the next 20 years?
If you look at the breakdown of the foundation spending, which is just over $100 billion over the last 25 years, by far the biggest is in global health, with 35% creating new, low-cost tools and 35% helping to get those tools delivered.
Next up is education, which is about 15%. That's always been something where because I got such a great education here in the U.S., I felt like we should try to make that available to every student. We have done a lot with charter schools, curriculums, and scholarships. Now, we are using AI to improve curricula. We are able to get graduation levels up.
Agriculture is 8% of what we have done. The opportunity to make seeds more productive, and crops more nutritious either by improving seeds or doing food fortification by adding some micronutrients in later—that's super important work. Particularly in Africa where with population growth and climate change, the only way to help the poorest there—the majority of whom are farmers—is by improving their seeds and access to fertilizer.
One of the most amazing programs we've done is taking chickens in Africa and used cross-breeding with highly productive chickens from Europe and the U.S. to get a lot more eggs. Now we have over 200 million chickens that have been delivered to women in Africa that both help nutritionally, and help them economically. It's a very exciting area. The agriculture work has as high impact as our health work.
How well has the foundation addressed the goals and vision you set out when you created it 25 years ago?
The progress in health is way beyond what I would have expected. Tens of millions of lives have been saved because of our work and through our partnerships—over 100 million lives. It's not just us. There has been a movement, and we have been a central part of that.
In areas like education, we have done great things—graduation rates have gone up but not nearly as miraculous. I slightly expected us have more impact in education and I had no idea we we'd be able to have such incredible results in our health work. So we're learning all the time. We've got a pipeline of innovation that is far, far stronger than ever before. And we have AI that's going to supercharge that—both the discovery piece and the delivery piece. So I have pretty high expectations for the next 20 years, despite the funding emergency that we're in .

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Graphs that paint the picture of HIV in SA: Part 3
Graphs that paint the picture of HIV in SA: Part 3

News24

time21 minutes ago

  • News24

Graphs that paint the picture of HIV in SA: Part 3

Eight million people living with HIV. Just over 6 million on treatment. Behind these big numbers lurk a universe of fascinating epidemiological dynamics. In this special briefing, Spotlight editor Marcus Low unpacks what we know about the state of HIV in South Africa. This is part 3 of 3. In Part 1 of this Spotlight special briefing, we looked at some of the big picture dynamics of HIV in South Africa, and in Part 2, we considered some of the vulnerabilities of our HIV programme. Now, in Part 3, we zoom into some nuances relating to HIV prevention, the epidemic in different provinces, gender disparities, and HIV in kids – after which we conclude this special briefing with our take on where all this data suggests we should be focussing next in South Africa's HIV response. Prevention problems A landmark analysis published in 2022 found that the key reasons for the large decline in new infections in South Africa were antiretroviral treatment (since it makes people non-infectious) and the use of condoms. Voluntary medical male circumcision also contributed to reduced infections, more so for men, but also indirectly for women. To some extent, all of these interventions are threatened by the recent aid cuts. Even prior to the cuts there were concerns that both condom distribution and usage has declined. Incidentally, the provision of condoms is probably the area of HIV prevention that has been impacted least by the aid cuts. Last year, we reported extensively on injections that can provide HIV-negative people with six months of protection against HIV per shot. There are big unanswered questions about when these injections will become available and at what price, but experts have described it as a potential game-changer. In the meantime, daily antiretroviral tablets that prevent HIV infection have already been rolled out in the public healthcare system over the last five or so years. The numbers here are tricky to parse since many people start taking the pills and then stop. For example, while 501 000 women started taking the pills from mid-2023 to mid-2024, less than half that number were still taking the tablets in mid-2024 – keep this in mind when considering the above graph. Even so, there has clearly been a dramatic increase in women using HIV prevention pills in recent years. How provinces compare In South Africa, the health system, and most of the HIV programme for that matter, is run by provincial health departments. Apart from demographics differing massively between the country's nine provinces, the capabilities of their health departments also varies. It is thus no surprise that the HIV numbers look very different in different provinces. Part of the difference between provinces is determined by things health departments can do little about, for instance the Eastern Cape quite simply is a more rural province than Gauteng. On the other hand, some provincial departments have been chronically dysfunctional for decades which has no doubt impacted their HIV numbers. Gauteng and KwaZulu-Natal (KZN) are comfortably the country's largest provinces by population, and it is thus no surprise that together they account for over 60% of all the country's HIV cases. But apart from their absolute numbers, they also have particularly high HIV prevalence – roughly 16% of people in KZN are living with HIV, compared to 7% in the Western Cape. In terms of treatment coverage, the three worst performing provinces are the Eastern Cape, Gauteng, and Limpopo – all at around 73%. At 74%, the Western Cape is not much better. KZN leads the pack with 84%. We focus on treatment coverage here since we consider it the single number that tells us most about how well a province is doing. Maybe the most important contrast here is that between KZN and Gauteng. Both provinces have just under two million people living with HIV. Conventional wisdom would have it that delivering treatment would be harder in a more rural province like KZN, yet treatment coverage in KZN is more than ten percentage points higher than it is in Gauteng. It is worth noting though that estimated HIV-related deaths are nevertheless higher in KZN than in Gauteng – possible explanations include much higher TB rates in KZN and worse socio-economic conditions. Differences between men and women One of the most striking aspects about HIV in South Africa is that almost double as many women as men are living with the virus – 5.2 million versus 2.6 million in 2024. The reasons for this are not entirely clear but it is likely due to a combination of biology and social factors that determine who has sex with who. Given these numbers, one might expect that many more women would be dying of HIV-related causes than men, but that is not what is happening. In fact, in 2023/2024, 27 100 men died of HIV-related causes compared to 24 200 women. Men are thus less likely to contract HIV than women, but once they have the virus in their bodies, they are on average much more likely to die of it than women. The numbers suggest that this is at least in part because men are both less likely than women to get tested for HIV and to take treatment once diagnosed. The kids are not quite all right It may come as a surprise to some that, even in the mid-2020s, we still have around 7 000 new HIV-positive babies every year in South Africa. Things have improved massively since two decades ago when the number was more than 10 times higher, but it is worrying that we haven't been able to get it closer to zero. In fact, progress has slowed in recent years. The dynamics here are not obvious. Most pregnant women in South Africa attend antenatal visits where they are routinely offered HIV testing. If the mother tests positive, she is immediately put on antiretroviral treatment that can suppress the virus and protect both her and the baby. Because of such HIV testing in the antenatal period, we have seen dramatically fewer vertical (mother-to-child) transmissions at or during birth. Instead, an increasing proportion of vertical transmissions happen in cases where the mother only contracts HIV in the months after birth and then transmits the virus to her baby during breastfeeding, all before she herself has been diagnosed. Since a person's HIV viral load spikes very high in the first weeks after infection, this can happen very quickly. Apart from ongoing vertical transmissions, another point of concern is the estimate that one in three children living with HIV are not taking antiretroviral treatment. (We have unpacked the dynamics behind this in a previous article.) What is to be done? In a study conducted in KwaZulu-Natal a few years ago, researchers found that people with HIV who only visited the clinic once a year did as well as people who visited the clinic every six months. The nurses at the facilities involved were however convinced that the 12-month group would be worse off – if it was up to them everyone would have to come every six months. Well-intentioned as these nurses were, doing it their way would mean more work for them and more clinic visits and more waiting in line for their clients. Of course, for those people who are ill or struggling, there must be the option of much more regular visits. But for those who are stable on treatment and doing well, we should at most be asking them to visit the clinic once a year and pick up medicines somewhere convenient every six months. ALSO READ | Are children living with HIV being left behind? What the stats tell us South Africa has made tremendous progress against HIV. Yet, as we have shown in this Spotlight special briefing, there are gaps, most notably the fact that one in five people living with the virus are not on treatment. Getting that fifth person on to treatment, might require us doing things differently than before. Quite simply, we need to make it easier and more convenient for people to start and stay on treatment. We have already made several of the right moves. Condom distribution has mostly been a success, it is easy to get an HIV test, allowing nurses to get people started on treatment without the involvement of doctors has worked well, and giving people the option of collecting their ARVs at pick-up points such as private pharmacies has made many people's lives easier. ALSO READ | Francois Venter: Our HIV programme is collapsing and government is nowhere to be seen Though it's come a long way, the medicines distribution system still falls short of providing everyone with a convenient option for collecting their medicines near their home or workplace. Too often people still get only enough tablets for a month or two at a time. For those not keen on visiting clinics, getting an ARV prescription straight from a pharmacy is unfortunately not yet an option. Many people still feel disrespected by the health system meant to support them. Over the last two decades, we have rightfully been somewhat fixated with numbers like treatment coverage. One might argue that to scale up treatment as quickly as we did, we couldn't afford for care to be as personalised as we'd like. But with the world's largest treatment programme in place and a mature epidemic, the context has changed. It is clear where the remaining gaps are – closing those gaps will require that government gets serious about making the health system much, much more friendly to those it is meant to support. *You can find the complete version of this #InTheSpotlight special briefing as a single page on the Spotlight website. Note: All of the above graphs are based on outputs from version 4.8 of the Thembisa model published in March 2025. We thank the Thembisa team for sharing their outputs so freely. Graphs were produced by Spotlight using the R package ggplot2. You are free to reuse and republish the graphs. For ease of use, you can download them as a Microsoft PowerPoint slide deck. Technical note: The Thembisa model outputs include both stock and flow variables. This is why we have at some places written 2024 (for stock variables) and 2023/2024 (for flow variables). 2024 should be read as mid-2024. 2023/2024 should be read as the period from mid-2023 to mid-2024. Reviewed by Dr Leigh Johnson. Spotlight takes sole responsibility for any errors. Show Comments ()

Advocates, legislators still trying to expand expired compensation program for radiation exposure
Advocates, legislators still trying to expand expired compensation program for radiation exposure

Yahoo

time4 hours ago

  • Yahoo

Advocates, legislators still trying to expand expired compensation program for radiation exposure

Jun. 10—One year ago, Congress let a federal program end that compensated people who grew sick from mining uranium for nuclear weapons or from living downwind of nuclear weapons tests. In those 12 months, Tina Cordova's cousin died after years of living with a rare brain cancer. Under a proposed expansion of the program, 61-year-old Danny Cordova likely would have qualified for the $100,000 compensation offered to people with specific cancers who lived in specific areas downwind of aboveground nuclear weapons' tests. "Instead, he and his mom lived literally paycheck to paycheck trying to pay for all of the medications he needed," Cordova said. Since the Radiation Exposure Compensation Act (RECA) program was created in 1990, New Mexican downwinders have been left out, as have uranium mine workers from after 1971. Sen. Ben Ray Luján, D-N.M., has led an effort in the Upper Chamber alongside Sen. Josh Hawley, R-Mo., to expand the program so it includes later uranium mine workers, and people harmed by aboveground nuclear tests in more states — including New Mexico. In January, they reintroduced a bill to extend and expand RECA. "Letting RECA expire is a disgrace to these families and victims," Luján said. "It's an insult to the victims and their families who still struggle to this very day to get help, get the medicine they need, get the treatments for the conditions caused by the negligence of the federal government. For the victims, this story is long from being over. Generational trauma and poor health conditions continue to plague entire families." Although Hawley and Luján's bill passed the Senate twice in the last session of Congress, and was supported by the entire New Mexico delegation, House Speaker Mike Johnson, R-La., never allowed a vote on the companion House bill, sponsored by Rep. Teresa Leger Fernández, D-N.M. The expansion would have included an increased pricetag of $50 billion to $60 billion over 10 years, according to the nonpartisan Congressional Budget Office — a cost estimate Luján has disagreed with. Since its inception, RECA has paid out approximately $2.6 billion. There is no accurate estimate of how many New Mexicans would be included if RECA is expanded, according to Luján's office. "We know we have the votes to get this passed now," said Leger Fernández, who plans to reintroduce the bill in the House. "They keep raising issues with regards to the cost... These are people's lives, and so we need to keep bringing it back to that issue. And in many ways, I think that we are doing this in a bicameral manner, and that the pressure that is being brought from the Senate will help us in the House." 'No apology' Cordova's cousin was diagnosed in his 20s, and had five brain surgeries to address his cancer. "He was left with horrendous and devastating consequences of that (first) surgery," Cordova said. "He lost the eyesight in one eye, he lost the part of his brain that controlled all of his hormonal functions, and he lost the part of his brain that also controlled his ability to adapt his body temperature." Five generations of Cordova's family tree include many cases of cancer. She herself survived thyroid cancer, and as a co-founder of the Tularosa Basin Downwinders Consortium, she's long advocated for expanding RECA. Cordova's kitchen counter is covered in the stories of family trees that mirror her own. For 18 years, she's been collecting health surveys from people who grew up in areas downwind of aboveground nuclear weapon tests, documenting a history of cancer and death for families from Tularosa, Alamogordo and beyond. Loretta Anderson, a patient advocate and co-founder of the Southwest Uranium Miners Coalition Post-71, works with over 1,000 former uranium miners and their families throughout the Laguna and Acoma pueblos. She knows 10 post-1971 uranium miners, those who would be compensated under a RECA expansion, who have died in the past 12 months. "They died with no compensation, no apology from the government," Anderson said. Despite the difficulty in getting RECA extended and expanded, Cordova has faith it will eventually pass through Congress. "This is not a partisan issue," Cordova said. "Exposure to radiation has affected the young, the old, the male, the female, the Black, the white, the Republican and Democrat alike."

NIH Revolts: Scientists Decry Budget Cuts, RFK Jr. Political Interference, Warn Of Long-Term Public Health Damage
NIH Revolts: Scientists Decry Budget Cuts, RFK Jr. Political Interference, Warn Of Long-Term Public Health Damage

Yahoo

time6 hours ago

  • Yahoo

NIH Revolts: Scientists Decry Budget Cuts, RFK Jr. Political Interference, Warn Of Long-Term Public Health Damage

Over 340 current and recently terminated U.S. National Institutes of Health (NIH) employees have publicly protested the Trump administration's deep cuts to the agency's research budget. What Happened: Reuters noted that more than 60 NIH employees signed a letter, accusing NIH leadership — including Health Secretary Robert F. Kennedy — of allowing political interference to override scientific priorities. The stakes are high, they noted, citing how patient safety is at risk and public resources are wasted. Trending: Maker of the $60,000 foldable home has 3 factory buildings, 600+ houses built, and big plans to solve housing — Signatories claim in the letter that the agency has eliminated 2,100 research grants worth $9.5 billion and cut another $2.6 billion in research contracts since Trump took office in January. The letter, also addressed to NIH Director Dr. Jay Bhattacharya and members of Congress, comes ahead of Bhattacharya's scheduled testimony before the Senate Appropriations Committee on Tuesday. The letter states that the cuts have halted clinical trials and left patients without oversight for experimental treatments or implanted devices. The employees told Reuters the terminated programs represented years of work and financial investment. They warned that the cuts were made without proper review, sometimes bypassing peer evaluations in favor of political It Matters: Bhattacharya said the letter mischaracterized NIH's recent policy directions. Citing internal staff reports, Reuters highlighted that the Trump administration has proposed slashing NIH's budget by $18 billion next year. This would reduce it by 40% to $27 billion. Nearly 5,000 NIH employees and contractors have already been laid off under Kennedy's restructuring of U.S. health agencies. In February, a complaint was filed arguing that 'Without relief from NIH's action, these institutions' cutting-edge work to cure and treat human disease will grind to a halt.' The lawsuit also mentioned, 'In issuing the Rate Change Notice, the NIH has also acted beyond its statutory authority and has failed to promulgate the change using notice and comment rulemaking.' In March, The U.S. Department of Health and Human Services (HHS) unveiled a sweeping restructuring plan to cut costs, streamline operations and refocus priorities. The restructuring will reduce the HHS workforce by 10,000 full-time employees, leading to annual savings of $1.8 billion. Through early retirements and other initiatives, the total number of employees will shrink from 82,000 to 62,000. Read Next: The average American couple has saved this much money for retirement — How do you compare? If there was a new fund backed by Jeff Bezos offering a 7-9% target yield with monthly dividends would you invest in it? Image: Shutterstock Up Next: Transform your trading with Benzinga Edge's one-of-a-kind market trade ideas and tools. Click now to access unique insights that can set you ahead in today's competitive market. Get the latest stock analysis from Benzinga? This article NIH Revolts: Scientists Decry Budget Cuts, RFK Jr. Political Interference, Warn Of Long-Term Public Health Damage originally appeared on

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