Gates Foundation unveils Sh26trn final push to end preventable deaths
The foundation's priority remains ensuring that "no mother, baby, or child dies of a preventable cause."
What you need to know:
- Beyond maternal and child health, the foundation's second goal envisions that "the next generation grows up in a world without deadly infectious diseases."
The Gates Foundation has outlined an ambitious roadmap for its final two decades of operation, focusing its $200 billion (Sh25.8 trillion) spending plan on three core goals aimed at reshaping global health and economic opportunity by 2045.
In its 2026 annual letter released last week, the foundation’s Chief Executive Officer Mark Suzman acknowledged the challenging global landscape, noting that "faced with compounding crises and competing priorities, leaders everywhere are making hard decisions about how to do more with less."
Despite these constraints, the foundation's priority remains ensuring that "no mother, baby, or child dies of a preventable cause." This goal responds to a troubling reversal whereby, after two decades of historic declines in child mortality, deaths began rising again in 2025—the first such increase this century.
"It's not as if the world forgot how to save children's lives. It just wasn't prioritised," Mr Suzman wrote. "Millions of children died the most tragic kind of death—a preventable one."
To address this crisis, the foundation will concentrate on three proven areas: vaccines, which it describes as "the best buy in global health"; maternal and child health services; and nutrition programmes. Malnutrition, Mr Suzman noted, is "the underlying cause of half of child deaths."
Central to this strategy is the foundation's 2025 commitment of $2.5 billion (Sh322.5 billion) to accelerate research in five chronically underfunded areas of women's health, including obstetric care and maternal immunisation, maternal health and nutrition, gynaecological and menstrual health, contraceptive innovation, and sexually transmitted infections.
The investment targets both immediate interventions, such as screening tools for pre-eclampsia, a poorly understood condition that often proves deadly in low-resource settings, and longer-term research that may take a decade to reach patients.
By pairing delivery of proven interventions with development of new diagnostics and treatments, the foundation aims to narrow stark geographic disparities in maternal and child survival.
Beyond maternal and child health, the foundation's second goal envisions that "the next generation grows up in a world without deadly infectious diseases."
By 2045, the foundation believes polio and malaria can be eradicated, while HIV and tuberculosis can be controlled as manageable conditions.
"This isn't wishful thinking but a realistic outcome if innovations in the pipeline today reach the people who need them," Mr Suzman wrote.
Current investments include promising tuberculosis vaccine candidates, with the M72 vaccine in trials in South Africa potentially becoming the first new TB vaccine in over a century.
Technology is expected to play a crucial role in achieving these goals. The foundation is deploying artificial intelligence to address critical health worker shortages through its Horizon 1000 partnership with OpenAI, which will bring AI tools to 1,000 primary health clinics across sub-Saharan Africa.
In a region facing a shortage of nearly six million healthcare workers, these tools can support everything from patient triage to follow-up care, helping overwhelmed professionals deliver higher-quality services to more people.
The third goal focuses on helping "hundreds of millions of people break free from poverty" through agriculture and education. The foundation emphasises that agricultural growth is "two to three times more effective at reducing poverty than growth in any other sector," particularly for the poorest households.
Its $1.4 billion (Sh180.6 billion) commitment at COP30 will support climate-resilient crops and digital advisory services for smallholder farmers.
Throughout the letter, Suzman maintained optimism despite current funding pressures. "We've seen what's possible when the world chooses to act together," he wrote, pointing to the start of the 21st century, which launched "two decades of unprecedented progress". He hopes that 2025's spike in child deaths will eventually appear as merely "an almost-forgotten time when progress hung in the balance, before the world got back on track."
The foundation describes its role as catalytic, taking risks to prove what works, then partnering with governments and communities to scale solutions.
