“It doesn’t have to be like this.” That’s how Bill Gates, chair of the Gates Foundation, opens the 2025 Goalkeepers Report, “We Can’t Stop at Almost.” The Microsoft cofounder sees a turning point after decades of progress in reducing childhood mortality. “The death of a child is always a tragedy,” he continues. “But there’s something especially devastating about a child dying of a disease we know how to prevent.”
For the first time this century, the report finds, the number of children dying before their fifth birthday is projected to rise. Modeling conducted by the Institute for Health Metrics and Evaluation (IHME) reveals alarming statistics: In 2024, 4.6 million children died before turning five. In 2025, that number is projected to increase by just over 200,000, reaching an estimated 4.8 million children globally. This increase means more than 5,000 classrooms of children are “gone before they ever learn to write their name or tie their shoes.” This alarming forecast comes amid sharp declines in global development assistance for health, which fell 26.9% below 2024 levels this year. In the U.S. the Trump administration has dismantled its aid agency, USAID, and drastically cut foreign aid.
