Bill Gates has publicly held Elon Musk responsible for what he describes as “millions of preventable deaths” among the world’s poorest children, following sweeping U.S. foreign aid cuts executed under Musk’s leadership at the Department of Government Efficiency (DOGE). The intense criticism comes in the wake of drastic measures that dismantled the U.S. Agency for International Development (USAID), which Gates says will have deadly consequences for global health and development.
In February, the Trump administration — with Musk heading DOGE — initiated severe budget reductions, resulting in over 90% of USAID’s overseas contracts being terminated. Gates, 69, warned that reversing decades of progress in fighting diseases like HIV, measles, and polio would become inevitable due to this disruption. “The number of deaths will start going up for the first time,” Gates stated, forecasting that the impact of these cuts could be felt for at least the next four to six years.
PEPFAR, a U.S. government program aimed at fighting HIV/AIDS globally, has reportedly lost its funding since January. This alone, Gates claims, may have already led to over 4,800 child deaths. USAID memos estimate that one million children could go untreated for severe acute malnutrition and around 200,000 may face paralysis from polio each year due to the cuts.
At the same time, Gates announced that the Gates Foundation will cease operations by December 31, 2045—decades earlier than planned—but will double its commitment to spend over $200 billion by then. This includes a ramp-up to an annual budget of $10 billion by 2026, focusing on global health, education, and development initiatives.
According to Quartz, “The government eliminated more than 90% of USAID’s overseas aid contracts and cut $60 billion in overall U.S. assistance around the world.” Quartz further notes that Musk’s role was instrumental in these decisions, citing his own post on X: “USAID is a criminal organization. Time for it to die.” Gates believes these policies directly correlate with rising death tolls in vulnerable communities.
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India Today reports that Elon Musk responded sharply on X, calling Gates “a huge liar.” The White House, however, stood firmly by Musk’s role, describing him as “a patriot working to fulfill President Trump’s mission to eliminate waste, fraud, and abuse.” DOGE officials maintain that the initiative is focused on protecting taxpayer funds, despite growing backlash from global health advocates.
In an interview with the Financial Times, Gates challenged Musk to personally visit children affected by HIV in the wake of the cuts. “The picture of the world’s richest man killing the world’s poorest children is not a pretty one,” he said. Gates also emphasized that while private philanthropy like the Gates Foundation plays a crucial role, it cannot fully replace the responsibility and scale of government aid.
Despite their differences, Gates concluded that he hopes Musk will eventually embrace a philanthropic path. “He could go on to be a great philanthropist,” Gates said, “but in the meantime, the world’s richest man has been involved in the deaths of the world’s poorest children.”
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