Bill Gates, the philanthropist and co-founder of Microsoft, has criticized the Trump administration for what he called “entirely preventable” humanitarian disasters stemming from the abrupt dismantling of U.S. international aid programs.
In a post on X (formerly Twitter) on Friday, Gates urged Washington to reverse course before the fallout becomes irreversible, warning that life-saving interventions are now at risk in vulnerable countries.
“The devastating effects of these cuts are entirely preventable — and it’s not too late to reverse them,” Gates wrote, sharing a post from journalist Sam Stein that included a harrowing message from an aid worker in Africa. According to the worker, vital HIV medications for children had not arrived in months, oxygen tubes for newborns were in short supply, and other essential treatments for sexually transmitted infections were running out.
“These are lives that can be saved,” Gates stressed.
The former tech executive’s criticism follows a series of sweeping changes to U.S. foreign assistance under President Donald Trump. Earlier this year, the Trump administration placed most staff members of the U.S. Agency for International Development (USAID) on administrative leave and announced that the agency would be absorbed into the State Department. By June 30, USAID — once a cornerstone of U.S. global engagement — was officially dissolved.
Secretary of State Marco Rubio, who now oversees foreign assistance programs, has insisted the U.S. is not abandoning its global role.
“Moving forward, our assistance will be targeted and time-limited,” he said, framing the restructuring as part of a pivot from traditional aid toward investment-led development.
But the shift has been widely condemned by humanitarian groups, economists, and even former government officials, who say the cuts have triggered a cascade of avoidable tragedies.
During a visit to Ethiopia last month, Gates addressed the cuts directly, stating: “A lot of cuts are being made in foreign aid programs,” he said during the visit, according to a transcript of the remarks. “Some of those cuts are being made so abruptly that there are complete interruptions in trials, or medicines are still sitting in warehouses and are not available. And these cuts are something that I think are a huge mistake.”
He added that the Gates Foundation, which has invested billions into global health, had long worked alongside USAID on key initiatives.
Among the most affected programs is the President’s Emergency Plan for AIDS Relief (PEPFAR), which is now under State Department review. The cuts have already halted shipments of antiretrovirals, contraceptives, malnutrition treatments, and routine vaccines in multiple African countries. A report by Wired revealed that therapeutic food for starving children is stockpiled in warehouses, blocked by bureaucratic confusion and funding freezes.
In addition to ending support for PEPFAR, the Trump administration has reportedly withdrawn U.S. backing from Gavi, the international vaccine alliance co-founded by Gates in 1999. The move has alarmed public health officials who fear resurgent outbreaks of polio, measles, and other preventable diseases.
In place of long-standing assistance programs, the administration is offering a new model: trade over aid. The U.S. is actively pursuing bilateral resource-for-investment deals with countries such as Senegal, Mauritania, Gabon, and Liberia. These “minerals-for-security” partnerships are pitched as mutually beneficial, but critics argue they signal a retreat from humanitarian leadership and a pivot toward transactional diplomacy.
In the Democratic Republic of Congo, for instance, the U.S. has promised security and infrastructure investments in exchange for access to rare earth minerals used in tech manufacturing.
Economists and humanitarian leaders have been vocal in their condemnation. Peter Konyndyk, a former USAID official, warned that dismantling the agency cripples America’s disaster-response capacity and hands strategic leverage to geopolitical rivals like China and Russia. Others point to a broader erosion of U.S. soft power as foreign policy priorities shift toward economic nationalism.
Gates, who last year pledged to give away nearly all his personal wealth within two decades, has been increasingly outspoken on the issue of foreign aid. In May, the Gates Foundation warned that “governments around the world have announced tens of billions of dollars in cuts to aid funding,” with the U.S. leading the trend. The foundation has since redoubled its efforts in Africa, attempting to fill the widening gaps in care and infrastructure.
Trump’s approach to foreign policy — emphasizing self-reliance over assistance — has sparked outrage within global development circles. Critics say the changes could reverse decades of progress in combating infectious diseases, reducing child mortality, and improving access to basic health services. While the White House continues to insist the aid model is outdated, Gates and others argue that the price of inaction will be counted in lives lost.