Ask the person sitting next to you who is the world’s most influential philanthropist and the name Bill Gates is likely to be the first mentioned. After amassing a fortune from his Microsoft empire, the billionaire decided to start a second career by turning his focus towards global public health. Launched in 2000, the Gates Foundation has grown to become the third biggest charitable trust in the world. Over the past quarter century his foundation has given away over $100bn in grant money, $60bn of which Gates donated from his personal wealth.  

Last week the billionaire pledged to go even further. On Thursday Gates announced he intends to close his foundation by the end of 2045, and before doing so will give away $200bn, roughly 99% of his vast fortune. The money will go towards achieving several of his goals such as eradicating malaria and polio, reducing global poverty, and ending preventable deaths of mothers and children.  

The announcement couldn’t come at a more urgent time. The US government has slashed foreign aid and funding for research into global public health which has had an immediate impact on the lives of the world’s most vulnerable people. In Sudan over 1,000 community kitchens have closed that were feeding two million people. Predictions from Boston University estimate that by the end of the year 176,000 adults and children could die preventable deaths from HIV due to the cancellations of USAID projects. Other governments including the UK, France, and The Netherlands have announced similar cuts in foreign aid with a diversion of funding into defence. 

Bill Gates does not attribute his decision to close his foundation to the recent spending cuts in foreign aid, but rather to an alarming international trend in declining health outcomes. In a conversation with The New York Times, the billionaire celebrated the achievements of his foundation over the last 25 years reducing childhood mortality from 10 million childhood deaths to five million. When asked if he thinks it possible to halve those numbers again in the next two decades he responded “absolutely” before adding the caveat that doing so will require huge amounts of funding that nobody is contributing.  

 “In the next four years — or eight years, I don’t know — the actual money going into these causes is reduced, and reduced way beyond what I would have expected. On childhood deaths, which over the next few years should have gone from five million to four million — now, unless there’s a big reversal, we’ll probably go from five million to six million.” 

The Gates Foundation has made a decisive dent in global health statistics since its launch at the turn of the century. In 2000 HIV/AIDS was decimating populations across the global south, 1,000 children were paralyzed by polio per day, and even though malaria killed nearly a million children each year, there was no vaccine available on the market.  

Today HIV is no longer the death sentence it once was. The Gates Foundation was one of the leading donors of HIV research leading to the development of antivirals that have saved millions of lives. His foundation has contributed over $3bn in HIV grants, and another $3bn to The Global Fund to fight AIDS, Tuberculosis, and malaria. The Gates Foundation has supported polio vaccination campaigns that have reached nearly three billion children, reducing the number of new cases by 99%. In 2015 the world’s first malaria vaccine, backed with funding from the Gates Foundation PATH Initiative, received approval for use in babies in Sub-Saharan Africa.  

And while the achievements of the last two decades have been massive, Gates believes the next two could be “miraculous” due to exciting research he has funded that is currently in the pipeline. He points to his HIV Frontier Program which he hopes will find a genetic cure for HIV that will “change the world permanently” for the millions of people living with the disease, and calls the research into Tuberculosis “mind-blowing”. He also points to exciting developments in AI that could lead to new advances in drug discovery, education, and agriculture.  

Walk the walk 

When asked why he decided to close his foundation in 2045 Gates gives very whimsical answers. By then the billionaire will be 90 years old living in a world he believes will be significantly changed by technology and politics. “There will be more rich people, and they will also see what A.I. has done and not done, and what politics and governments have done and not done. And I do think good examples influence other people.”  

In his note announcing the closure of his foundation, Bill Gates quoted Andrew Carnegie’s Gospel of Wealth with the famous line: “The man who dies thus rich dies disgraced.” At a time when wealth is concentrating more in the hands of the few, and with those few giving even less of it back, Gates has demonstrated the power of empathy to change the world for the best.  “People will say a lot of things about me when I die, but I am determined that “he died rich” will not be one of them,” Gates wrote, “There are too many urgent problems to solve for me to hold onto resources that could be used to help people.”  

Bill Gates will surely be remembered for his achievements in technology and business. But his real legacy will be in demonstrating the meaning of philanthropy, “a love of mankind.”