A kid born in northern Nigeria has a 15% chance of dying before the age of five, philanthropist Bill Gates announced on Monday as he urged governments to reverse global health funding cuts.

Speaking at a Reuters Newsmaker event in New York, Gates said the world was at a crossroads, with millions of children at risk of dying if funding drops too steeply.

“You can either be part of improving that or act like that doesn’t matter,” Gates said in an interview before the foundation’s annual Goalkeepers event in New York on Monday, as reported by Reuters.

The Gates Foundation will give $912 million to the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

The announcement follows deep aid cuts from governments around the world, led by the United States.

“I am not capable of making up what the government cuts, and I don’t want to create an illusion of that,” he said about his pledge.

The Gates Foundation, the philanthropy started by the Microsoft co-founder and his then-wife in 2000, is one of the world’s biggest funders of global health initiatives, with a particular focus on ending preventable deaths of mothers and babies, tackling infectious diseases, and lifting millions out of poverty.

Earlier this year, Gates pledged to give away almost his entire $200 billion fortune by 2045, more quickly than planned because of the urgent need worldwide.

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According to the U.S.-based Institute for Health Metrics and Evaluation, global development assistance fell by 21% between 2024 and 2025 and is now at a 15-year low.

That could still change, said Gates, with organisations like the Global Fund trying to raise money before the end of the year. But if the trajectory remains the same, progress that cut child mortality in half since 2000, saving five million lives a year, could be in jeopardy, he said in a statement.

Gates said that there was still an opportunity to save millions of lives and end some of the deadliest childhood diseases by the time he will have donated the rest of his fortune in 2045.

That would require maintaining funding for institutions like the Global Fund as well as Gavi, the Vaccine Alliance, prioritising primary healthcare and rolling out innovations – such as the long-acting HIV prevention drug lenacapavir – quickly.

“What’s happening to the health of the world’s children is worse than most people realise, but our long-term prospects are better than most people can imagine,” Gates said in a statement.

While other countries reduced global health support, Spain increased its donations to the Global Fund this year by 12% and Gavi by 30%.