Cuts to humanitarian aid, led largely by the Trump administration in the US, will result in the deaths of 200,000 more children under the age of five, according to new research. 

A report from the Gates Foundation has predicted that, by the end of 2025, there will have been 4.8 million child deaths, mostly in places hit by humanitarian crises, compared with 4.6 million last year. 

The figure is unprecedented this century. Until this year, deaths of under-fives around the world had fallen every year since 2000, when the toll stood at 10 million. 

The ‘2025 Goalkeepers Report’ says that by far, the largest single cause of death is the cuts in humanitarian international aid. 

If funding for health decreases by 20 per cent, in line with the cuts proposed by a number of nations, 12 million more children could die by 2045, the report says. 

Chair of the foundation Bill Gates said: “The death of a child is always a tragedy. But there’s something especially devastating about a child dying of a disease we know how to prevent. For decades, the world made steady progress saving children’s lives. But now, as challenges mount, that progress is reversing. 

“That means more than 5,000 classrooms of children, gone before they ever learn to write their name or tie their shoes.” 

The Gates Foundation produced the report in partnership with the University of Washington’s Institute for Health Metrics and Evaluation. 

The largest cut to aid has come from the US, since Donald Trump became president. The Trump administration cancelled all foreign aid immediately. 

Gates Foundation CEO Mark Suzman said most of the 200,000 children will die from preventable causes and direct result of the cuts. 

US funding for global health is now two-thirds below what it was in 2024. The UK and EU countries are also in the process of slashing their foreign aid budgets. 

One impact will be the risk of tens of thousands more children dying on malaria, the report says. 

Mr Suzman called on wealthy countries to fund effective tools such as vaccines and mosquito nets. 

“This would represent a tiny proportion of their national budgets but have a disproportionate impact in terms of saving lives across low- and middle-income countries,” he said. 

Malaria is the world’s biggest killer of children, who make up more than 75 per cent of the 600,000 people die of the disease each year. 

The report also says that less than $US100 per person per year to shore up healthcare systems could prevent as much as 90 per cent of child deaths, while every dollar spent on vaccines gives countries a return of $54. 

“That is in fact the best way to help those low-and-middle-income countries themselves build the long-term self-reliance which they aspire to,” Mr Suzman said. 

Writing in the foreword of the report, Mr Gates says its findings are “sobering”. 

“For decades, the world made steady progress saving children’s lives. But now, as challenges mount, that progress is reversing,” he said. 

“In 2024, 4.6 million children died before their fifth birthday. In 2025, that number is projected to rise for the first time this century, by just over 200,000, to an estimated 4.8 million children.  

“It doesn’t have to be like this. The way I see it, there are two ways the next chapter can play out. 

“We could be the generation who had access to the most advanced science and innovation in human history—but couldn’t get the funding together to ensure it saved lives,” Mr Gates said. 

Read the full report: https://www.gatesfoundation.org/goalkeepers/report/2025-report/#WeCantStopAtAlmost