Gates Foundation CEO Mark Suzman Calls for Global Cooperation as Aid Funding Slumps

There’s no question it’s been a turbulent year for global health. Foreign aid has fallen by more than 25 percent, wealthy countries are making 11-figure cuts to health and development funding, and low-income countries are seeing their limited resources further strained by debt. In the face of such challenges, however, the Gates Foundation isn’t backing away from global aid but doubling down—and urging others to do the same.

“These are real constraints—but not permanent ones,” said Mark Suzman, CEO of the Gates Foundation, in an annual letter published today (Feb. 3). “And while these conditions will have significant repercussions for global health and development for the next few years, priorities can shift. Debt can be restructured. Generosity can return.”

Calling for global cooperation is a key aspect of the Gates Foundation’s plan for the next two decades as it prepares to accelerate progress across areas like global health, education and economic prosperity. The organization, which was founded by Bill Gates and his then-wife, Melinda French Gates, in 2000, last year unveiled plans to spend down its endowment before winding down in 2045.

The foundation’s goals have taken on added urgency amid global aid cuts led by high-income nations such as the U.S. Over the past year, the U.S. has slashed funding for agencies like the U.S. Agency for International Development (USAID) and withdrawn support for vaccine alliance Gavi—although it did pledge $4.5 million to the Global Funding, a financing partnership fighting AIDS, tuberculosis and malaria.

Such budget cuts have been linked to a troubling reversal in child mortality trends worldwide. For the first time this century, child deaths are estimated to have risen in 2025 compared to the previous year, increasing from 4.6 million to 4.8 million, according to the Gates Foundation.

“It just wasn’t prioritized,” said Suzman. “Funding and attention went elsewhere, even though we know more about how to save lives now than at any other time in human history.”

The Gates Foundation knows it can’t fill the global aid gap alone. That’s why the next two decades will be marked by an emphasis on strengthening existing coalitions and building new ones. “What the world needs now is a new era of cooperation centered on saving and improving lives,” said Suzman, who outlined the foundation’s goal of mobilizing other donors and working with governments in low- and middle-income countries to stretch resources more sustainably.

The road to 2045 will also bring a sharper focus to the foundation’s priorities. Going forward, the organization will funnel 70 percent of its resources into reducing maternal and child mortality in the global South and eradicating deadly infectious diseases like polio and malaria. Its third goal will focus on boosting economic prosperity through investments in education and agriculture.

A.I. will play a role across all three areas, said Suzman, noting that the Gates Foundation has already entered into strategic partnerships like Horizon1000, a $50 million collaboration with OpenAI to strengthen A.I.-powered health care in African countries.

The Gates Foundation is acutely aware of its influence as the world’s largest private foundation. With an endowment of $86 billion as of July, the organization has already distributed more than $100 billion since its inception. And it plans to spend twice as much between now and 2045.

Despite its vast resources, the foundation will need to streamline operations to maximize the impact of its grants. Last month, it announced its largest-ever annual spending budget of $9 billion, alongside plans to reduce its workforce by 500 roles over the next five years. Some of the affected positions will be tied to programs that have closed or will wind down soon, including the  Inclusive Financial Systems program and U.S. Economic Mobility and Opportunity program.

As the Gates Foundation moves forward with its sunsetting mission, it remains optimistic that its core priorities can transcend boundaries and attract broad support. “These are goals that I hope people of all backgrounds, faiths and political convictions can agree on,” said Suzman.