In the face of aid cuts, Gates Foundation narrows its priorities and defends global health funding

Despite global aid cuts, the Gates Foundation is doubling down on its core missions over its final two decades of operation, according to CEO Mark Suzman. The organization will dedicate at least 70% of its funding to addressing preventable maternal and child deaths and controlling infectious diseases, with remaining resources focused on poverty reduction through U.S. education and agricultural development in lower-income nations.

“We are saying not only will we not be taking on new priorities, we’re actively narrowing our priorities against three core North Star goals,” Suzman told The Associated Press as the foundation published its annual strategy update on Tuesday.

The announcement provides greater clarity on the foundation’s direction following Bill Gates’ May revelation that the organization would close in 20 years, earlier than initially planned. This accelerated timeline has prompted the foundation to refine its focus and eliminate several programs.

Despite widespread cuts to foreign assistance by donor countries that could significantly impact global health initiatives, Suzman expressed optimism about potential future shifts in international priorities. “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,” he wrote in the foundation’s letter.

The foundation appears particularly hopeful that the United States, historically the largest funder of global health programs, will eventually resume its leadership role. “We definitely have not lost hope that the U.S. will stay engaged over the medium and longer term as a champion of global health,” Suzman said.

U.S. foreign assistance faces an uncertain future under the incoming administration. While the U.S. recently refused to fund Gavi, which provides vaccinations to children worldwide, it did pledge continued support for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

As part of its narrowing focus, the foundation will wind down several initiatives. Its program aimed at expanding digital financial services access in sub-Saharan Africa and South Asia will conclude, with Suzman noting they expect that goal to be met by 2030 through other means. The foundation’s U.S. poverty reduction program, launched in 2022 with a $460 million commitment, will also end, though elements will continue through a recently announced partnership focused on developing AI tools for frontline workers.

The foundation plans to maintain a steady annual budget of $9 billion for the next five years, regardless of market fluctuations. This spending level will likely increase thereafter as the organization works to fulfill Gates’ commitment to distribute the remainder of his fortune through the foundation by 2045. Operating expenses will be capped at 14% of the annual budget, with workforce reductions expected by 2030.

Artificial intelligence represents a significant investment area for the foundation’s remaining years. In January, it announced a $50 million partnership with OpenAI’s for-profit subsidiary to develop AI applications for primary health clinics in Rwanda, with potential expansion to other countries. The foundation requires corporate partners to offer any developed technologies to poorer countries without markup.

“Wherever possible, we’re looking for things that are going be interoperable and open source to allow for these very new public goods,” Suzman explained, emphasizing the importance of avoiding vendor lock-in.

The foundation also sees promise in AI applications for education reform in the United States, an area where previous foundation initiatives haven’t achieved desired outcomes. Similarly, AI tools delivering weather information to small-scale farmers represent another potential high-impact application.

Dr. John Halamka, a physician and president of the Mayo Clinic Platform who has previously collaborated with the Gates Foundation, emphasized the importance of local involvement in these technological initiatives. “How do you ensure these kinds of tools will be used, trusted, adopted?” he asked. “And what are you doing to make the population comfortable with the use of these new technologies?”

The foundation’s strategic refinement occurred prior to recent media coverage of unsubstantiated claims regarding Bill Gates in released Jeffrey Epstein files, which Gates’ spokesperson has categorically denied.