Bill Gates is issuing a warning the world can’t afford to brush aside.

In the newly released Goalkeepers report, “We Can’t Stop at Almost,” he cautions that global progress in reducing child mortality is slipping backwards for the first time in decades.

He opens with a stark reminder: “It doesn’t have to be like this.” Yet the numbers tell a grim story. After years of steady decline, child deaths are rising again.

According to the Institute for Health Metrics and Evaluation, 4.6 million children under five died in 2024. That figure is projected to climb by more than 200,000 in 2025 — reaching an estimated 4.8 million.

Gates compares this loss to “over 5,000 classrooms of children gone before they ever learn to write their name or tie their shoes.”

What’s fueling the setback? A historic collapse in global health funding. Development assistance for health dropped nearly 27% in a single year, and several major international aid programs have been scaled back or dismantled entirely.

Gates calls the trend a “significant reversal in child deaths” — and a wake-up call for anyone who believes in scientific and humanitarian progress. The report warns that if funding continues to fall, the consequences could be catastrophic.

If global health support declines by 20%, an additional 12 million children could die by 2045. A 30% drop could push that number to 16 million.

He stresses a painful irony: the world now has the most advanced medical science in human history, yet risks failing to save lives that are fully within reach.

Earlier this year, Gates pledged nearly all his remaining wealth — about $100 billion — toward ending deadly diseases and reducing child mortality. Still, he insists philanthropy alone can’t fix the problem.

Governments, especially wealthier ones, must step up. Many infectious diseases can resurface rapidly if immunization programs and health systems are not consistently funded.

The report’s message is blunt: if the world turns away now, it will be remembered as the generation that almost ended preventable child deaths, almost eradicated polio, almost wiped out malaria, almost made HIV history — but stopped too soon.

Yet Gates remains hopeful, pointing to powerful tools already in hand. Strengthening primary health care could prevent up to 90% of child deaths with early diagnosis and basic treatment. Routine immunization remains one of the smartest investments in global health, offering enormous economic and social returns.

New breakthroughs — from advanced malaria prevention technologies to maternal vaccines against RSV and Group B strep — could save millions more lives in the coming years.