NEW YORK, Sep 23 — As world leaders converge on New York for high-level meetings at the United Nations General Assembly (UNGA), Bill Gates used the Goalkeepers 2025 event to issue a stark warning: proposed cuts to global health aid risk undoing two decades of progress in child survival, even as new innovations offer a chance to halve child deaths again by 2045.
Speaking to an audience of more than 1,000 government, philanthropic and private-sector leaders on the sidelines of UNGA, Gates unveiled a $912 million pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria’s 2026-2028 replenishment and urged governments to “do more with less” by sustaining proven initiatives and scaling affordable lifesaving technologies.
“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,” Gates said. “The choices they make now will determine what kind of future we leave the next generation.”
Bill Gates speaks at the Goalkeepers 2025 annual event in New York on September 22, 2025. /COURTESY.
According to the Institute for Health Metrics and Evaluation, global development assistance for health dropped 21 percent between 2024 and 2025 to a 15-year low. Gates said that unless countries reverse proposed cuts and prioritize primary health systems, decades of gains — including cutting child mortality from 10 million to under 5 million deaths a year since 2000 — could be lost.
A Roadmap for UNGA Leaders
The Gates Foundation presented a roadmap to halve child deaths again by 2045, calling on UNGA participants to:
Renew investments in the Global Fund and Gavi, the Vaccine Alliance.
Protect primary health care systems to prevent and treat illnesses early.
Invest in breakthrough innovations such as single-dose malaria treatments, long-acting HIV prevention, new maternal vaccines, and AI-driven medicine delivery.
“What’s happening to the health of the world’s children is worse than most people realize, but our long-term prospects are better than most people can imagine,” Gates said. “I believe governments can and will do what’s needed to save as many children as possible.”
Celebrating Champions Amid UNGA Momentum
At the event, the foundation awarded Spanish Prime Minister Pedro Sánchez the 2025 Global Goalkeeper Award for increasing Spain’s contributions to the Global Fund and Gavi and expanding official development assistance. Ten other “Goalkeepers Champions” from Africa, Asia, Europe and the U.S. were also recognized for their work in child survival — from Kenya’s Jerop Limo advancing HIV awareness to Uganda’s Krystal Mwesiga Birungi championing youth-centred health access.
The 2025 Global Goalkeeper Award was presented to Pedro Sánchez, President of the Government of Spain, recognizing his leadership in advancing international cooperation and amplifying the voices of the Global South.
The Global Fund’s replenishment, co-hosted by South Africa and the UK, closes in November. Gates said the level of investment in the next three years “will determine whether the world saves millions of lives; curbs HIV, TB and malaria; and bolsters economies and global health security.”
As high-level week continues at UNGA, health advocates are pressing governments to match Gates’ call with commitments of their own. The Goalkeepers event will move to Abu Dhabi in December to build further momentum.