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Bill Gates has lashed out at Elon Musk, accusing the world’s richest man of “killing the world’s poorest children” through huge cuts to the US foreign aid budget.
It comes as Gates pledged to give away $200bn via his charitable foundation by 2045.
The 69-year-old co-founder of Microsoft said he was speeding up his plans to divest almost all of his fortune and would close the foundation on 31 December 2045, earlier than previously planned.
Gates said he hoped the money would help eradicate diseases like polio and malaria, end preventable deaths among women and children, and reduce global poverty.
His announcement follows moves by governments, including President Donald Trump’s administration, to slash international aid budgets. The US cuts have been overseen by the Musk-led Department of Government Efficiency (Doge).
“The picture of the world’s richest man killing the world’s poorest children is not a pretty one,” Gates told the Financial Times.
In an interview with Reuters, Gates warned of a stark reversal to decades of progress in reducing mortality in the next four to six years due to the funding cuts.
“The number of deaths will start going up for the first time … It’s going to be millions more deaths because of the resources,” Gates said.
“I think governments will come back to caring about children surviving” over the next 20-year period, though, he said.
Gates and Musk, the CEO of Tesla and SpaceX, once agreed over the role of the wealthy in giving away money to help others but have since clashed several times. “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 in a post on his website.
“There are too many urgent problems to solve for me to hold onto resources that could be used to help people.”
He added: “It’s unclear whether the world’s richest countries will continue to stand up for its poorest people,” noting cuts from major donors including Britain and France alongside the US, the world’s biggest donor.

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Gates said that despite the foundation’s deep pockets, progress would not be possible without government support. He praised the response to aid cuts in Africa, where some governments have reallocated budgets, but said that, as an example, polio would not be eradicated without US funding. Gates made the announcement on the foundation’s 25th anniversary. He set up the organization with his then-wife Melinda French Gates in 2000, and they were later joined by billionaire investor Warren Buffett. “I have come a long way since I was just a kid starting a software company with my friend from middle school,” Gates said.

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Since its inception, the foundation has given away $100bn, helping to save millions of lives and backing initiatives like the vaccine group Gavi and the Global Fund to Fight AIDS, Tuberculosis and Malaria. It will close after it spends around 99% of Gates’s personal fortune, he said. The founders originally expected the foundation to wrap up in the decades after their deaths.
Gates, who is valued at around $108bn today, expects the foundation to spend around $200bn by 2045, with the final figure dependent on markets and inflation.
The foundation is already a huge player in global health, with an annual budget that will reach $9bn by 2026.
It has faced criticism for its outsized power and influence in the field without the requisite accountability, including at the World Health Organization.
Gates himself was also subject to conspiracy theories, particularly during the Covid-19 pandemic. He has spoken to Trump several times in recent months, and twice since the president took office on 20 January, he told Reuters on Thursday, on the importance of continued investment in global health.
“I hope other wealthy people consider how much they can accelerate progress for the world’s poorest if they increased the pace and scale of their giving, because it is such a profoundly impactful way to give back to society,” Gates said in the statement.