Joined by former President Barack Obama, the Microsoft co-founder will make the case for spending on development and health at the U.N. next week.
With more than $40 billion in assets and the world’s richest man at the helm, The Bill & Melinda Gates Foundation might seem well-positioned to ride out any political storm.
But the Trump administration’s proposal to slash funding for the global health and development causes the Seattle foundation holds dear sent shivers through even the country’s most powerful philanthropy.
Against that backdrop, the Gates Foundation is launching yet another salvo in its ongoing battle to convince Americans and federal lawmakers that foreign-aid spending matters — by pointing out what could happen if that spending is cut.
Among the findings of a new analysis released Wednesday is that even a 10 percent reduction in funding for AIDS treatment and prevention could lead to an additional 5 million deaths, mostly in Africa, by 2030.
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“We’re saying that progress is not inevitable,” Bill Gates said in a conference call with journalists from around the world. “ … It absolutely matters what happens here.”
The analysis from the University of Washington’s Institute for Health Metrics and Evaluation is part of the foundation’s push to draw attention to global health progress and gaps in conjunction with next week’s meeting of the United Nations General Assembly in New York.
“Up until now there has been tremendous support for global health by the U.S. government. and it’s been bipartisan,” said Jen Kates, director of global health and HIV policy for the Kaiser Family Foundation, which specializes in health-policy analysis. “I think this election threw much of that up in the air.”
Trump’s proposed “America First” budget would cut civilian foreign aid by about a third. That includes a $1.1 billion cut to a Bush-era program that has been credited with helping stem the global AIDS epidemic by boosting HIV testing and providing lifesaving drugs for nearly 12 million infected people worldwide. The budget also zeros out funding for birth-control and family-planning programs in the world’s poorest countries.
Gates said it appears Congress will reject those cuts and maintain funding at current levels in most areas. But he cautioned that the final outcome “still hangs in the balance.”
The Trump administration’s apparent lack of engagement in global health also threatens to create a leadership vacuum, said Kates, whose organization receives 3 percent of its funding from Gates. “The White House sets the overall tone.”
The new Gates report, called Goalkeepers, highlights progress since 1990 in a wide range of areas, including poverty levels, childhood deaths and malaria infections. In 2015, the U.N. adopted targets, called the Sustainable Development Goals, for progress by 2030 on those metrics and others. Gates said his foundation plans to issue similar reports annually until then.
The report maps out three possible futures: What’s expected at the current rate of improvement, how added support could accelerate progress, and the type of backsliding likely to occur if budgets are cut.
For example, the number of children dying before the age of 5 has dropped by 6 million in the past 25 years, Gates pointed out. “Even in that case, we still have 5 million children dying every (year),” he said. “We shouldn’t be satisfied where we are today.”
At current rates, the study projects childhood deaths will drop to about 3 million a year by 2030. If progress stalls, the toll could remain as high as 4 million.
Other yardsticks, including maternal mortality and rates of childhood stunting — the pernicious physical and mental deficiencies caused by malnutrition and disease — could remain virtually unchanged over the next two decades if progress stalls.
“Millions of lives hang in the balance,” Kates said.
No foundation, including one as wealthy as Gates’, can ever match the resources nations can bring to bear. But Melinda Gates recently announced an additional $375 million for her signature initiative to improve access to birth control for women in poor countries. And Bill Gates last month cashed in $4.6 billion in Microsoft stock and donated it to his foundation — his largest single gift since 2000.