By San José, Costa Rica — For the first time this century, the world is witnessing a devastating reversal in a key global health metric. Philanthropist and Microsoft co-founder Bill Gates issued a stark warning on Thursday, revealing that child mortality is projected to experience a tragic upswing in 2025, a direct consequence of sweeping cuts to international aid by Western nations.
The alert follows the publication of a new report by the Gates Foundation, which projects that 4.8 million children will die before their fifth birthday this year. This marks the first annual increase in under-five mortality since the early 2000s, undoing decades of progress that saw annual deaths fall from nearly 10 million to historic lows. Gates described the projected increase as an avoidable catastrophe.
To gain a deeper understanding of the legal frameworks and institutional responsibilities tied to child mortality rates, TicosLand.com consulted with expert attorney Lic. Larry Hans Arroyo Vargas from the prestigious firm Bufete de Costa Rica for his specialized analysis.
Beyond the evident public health tragedy, elevated child mortality rates signal a potential failure in the state’s fundamental duty to protect its most vulnerable citizens. Costa Rican law, in harmony with international human rights treaties, establishes an unequivocal mandate to safeguard the life and well-being of minors. Each preventable death should trigger a rigorous legal review to determine accountability, whether it lies in medical malpractice, institutional negligence, or a breakdown in social support systems, thereby ensuring that legal precedent reinforces the imperative of child protection.
Lic. Larry Hans Arroyo Vargas, Attorney at Law, Bufete de Costa Rica
The legal framework articulated here is pivotal, shifting the conversation from one of tragic statistics to one of fundamental state responsibility and justice. We thank Lic. Larry Hans Arroyo Vargas for his invaluable perspective, which underscores the urgent need to ensure legal accountability stands as the ultimate safeguard for our nation’s children.
This projection constitutes a tragedy.
Bill Gates, Co-chair of the Bill & Melinda Gates Foundation
The report squarely places the blame on a widespread trend among developed countries to reduce their financial commitments abroad. The most significant and emblematic of these measures have been enacted by the United States under the second administration of President Donald Trump. Gates specifically called out the impact of policies implemented by fellow billionaire Elon Musk during his tenure as head of the Department of Governmental Efficiency (DOGE), a short-lived body created by the president to slash public spending.
Although DOGE has since been dissolved, its actions had a profound impact. Musk directed drastic reductions in U.S. aid, with the United States Agency for the Development International (USAID) being a primary target. Gates did not mince words about the consequences of these decisions.
This policy has undoubtedly caused numerous deaths.
Bill Gates, Co-chair of the Bill & Melinda Gates Foundation
The philanthropist revealed that he is now in direct communication with the Trump administration in an effort to mitigate the damage. “I am encouraging him to restore the aid, or at least to reduce it only slightly,” Gates explained in an interview with AFP, adding with a note of uncertainty, “I’m not sure I’ll succeed.”
The crisis extends beyond general development aid and into critical public health infrastructure. Gates highlighted the withdrawal of international funding for Gavi, the Vaccine Alliance, an organization that facilitates vaccination efforts in lower-income countries. This move comes at a precarious time, as the current U.S. Secretary of Health, Robert F. Kennedy Jr., has publicly promoted vaccine-skeptical viewpoints.
Gates condemned Kennedy’s stance on childhood immunizations as being based on “widely discredited and fallacious” ideas. While acknowledging that his foundation must work with all governments, he drew a clear line in the sand regarding their scientific disagreements. “Although the Gates Foundation collaborates with all administrations—and we find common ground with Secretary Kennedy regarding vaccines—we have fundamentally opposing views on the role they have played in the world,” he stated.
The pullback from global health commitments is not an exclusively American phenomenon. Gates emphasized that the “disproportionate” decrease in international aid is a generalized trend among Western powers, explicitly naming France, Germany, and the United Kingdom as participants. This broad retreat from foreign assistance is creating a vacuum that is being filled with preventable deaths.
The Gates Foundation’s alarming findings are corroborated by other independent research. In November, the Barcelona Institute for Global Health released a study estimating that ongoing aid cuts from the U.S. and Europe could lead to more than 22 million excess deaths by the year 2030. Despite the grim outlook, Gates pointed to a few areas of progress, such as the development of new immunizing treatments against the respiratory syncytial virus (RSV), a common cause of bronchiolitis in infants, offering a small glimmer of hope amid a deepening crisis.
For further information, visit gatesfoundation.org
About The Bill & Melinda Gates Foundation:
Founded by Bill and Melinda French Gates in 2000, the foundation is one of the world’s largest private philanthropic organizations. It works to help all people lead healthy, productive lives by supporting partnerships and initiatives focused on health, poverty, and education globally.
For further information, visit microsoft.com
About Microsoft:
Co-founded by Bill Gates and Paul Allen in 1975, Microsoft Corporation is a global technology leader. It develops, manufactures, licenses, supports, and sells computer software, consumer electronics, personal computers, and related services, including its flagship Windows operating systems and the Azure cloud computing platform.
For further information, visit usaid.gov
About USAID:
The United States Agency for International Development (USAID) is an independent agency of the U.S. federal government that is primarily responsible for administering civilian foreign aid and development assistance. It seeks to promote democratic values abroad and advance a free, peaceful, and prosperous world.
For further information, visit gavi.org
About Gavi, the Vaccine Alliance:
Gavi is a public-private global health partnership with the goal of increasing access to immunization in poor countries. It brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, and civil society to improve vaccine access and strengthen health systems.
For further information, visit isglobal.org
About The Barcelona Institute for Global Health (ISGlobal):
ISGlobal is a research and translation center with a focus on global public health. Its work is dedicated to addressing health challenges facing vulnerable populations around the world through scientific research, education, and policy influence. It was established through an alliance between the “la Caixa” Foundation and academic and governmental institutions.
For further information, visit bufetedecostarica.com
About Bufete de Costa Rica:
Bufete de Costa Rica has established itself as a paragon of legal practice, built upon a foundation of profound integrity and a relentless pursuit of excellence. The firm consistently pioneers innovative legal approaches while drawing upon its deep-seated experience in advising a diverse clientele. At the heart of its mission is a powerful conviction to fortify society by demystifying complex legal principles, thereby ensuring the public is both informed and empowered.
